Managed Care Provider Relations Manager jobs in Albuquerque, NM

Managed Care Provider Relations Manager develops, manages, and sustains relationship with members of physician network of managed care service providers. Recruits new physicians and manages the credentialing and orientation process. Being a Managed Care Provider Relations Manager serves as a resource for physicians, answering questions and providing information about network procedures or contracts. Monitors provider performance and resolves any issues. Additionally, Managed Care Provider Relations Manager reviews billings and claims payments according to managed care contracts. Requires a bachelor's degree. Typically reports to the head of a unit/department. The Managed Care Provider Relations Manager manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. Extensive knowledge of department processes. To be a Managed Care Provider Relations Manager typically requires 5 years experience in the related area as an individual contributor. 1 to 3 years supervisory experience may be required. (Copyright 2024 Salary.com)

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Provider Relations Rep
  • Health Care Service Corp.
  • Albuquerque, NM OTHER
  • At HCSC, we consider our employees the cornerstone of our business and the foundation to our success. We enable employees to craft their career with curated development plans that set their learning path to a rewarding and fulfilling career. Come join us and be part of a purpose driven company who is invested in your future! Job Summary This position is responsible for enhancing relationships with facility and physician providers; and acting as liaison with providers through education, training, claims assistance and ongoing provider service. Required Job Qualifications: *Bachelor Degree and 1 year managed care experience in products or contracts OR 5 years’ experience in managed care environment with 1 year experience in products or contracts. *1 year experience in a position that demonstrates leadership abilities and sound decision-making. *Knowledge of contracts, applications and products; claims processing systems. *Knowledge and experience in provider reimbursement methods. *Meet deadlines and work well under pressure and take initiative to work independently. *Verbal and written communication skills; organizational and planning skills. *PC proficiency to include Microsoft Office. *Ability and willingness to travel, including overnight stays. Preferred Job Qualifications: *1 year experience in provider relations. *1 year experience in claims. *This is a hybrid role requiring 3 days in the office and 2 days remote weekly. We encourage people of all backgrounds and experiences to apply. Even if you don’t think you are a perfect fit, apply anyway - you might have qualifications we haven’t even thought of yet. #LI-Hybrid #LI-EL1 #INJLF Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process! HCSC Employment Statement: HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status. Join our talent community and receive the latest HCSC news, content, and be first in line for new job opportunities. Join our Talent Community. For more than 80 years, HCSC has been dedicated to expanding access to high-quality, cost-effective health care and equipping our members with information and tools to make the best health care decisions for themselves and their families. As an industry leader, HCSC also has been helping to make the health care system work better for all Americans. To remain a leader, we offer compelling careers that encourage resourcefulness, strategic thought and empower you to make a difference in the lives of our members and their communities. Today, with the industry at an important crossroad, HCSC is reimagining health care and looking for original thinkers who aren’t afraid to make innovative contributions. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Learn more about HCSC, our commitment to our members and the opportunity you’ll have to improve health care delivery in an open, collaborative environment. HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants. If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can call us at 1-866-977-7378 to request reasonable accommodations. Please note that only requests for accommodations in the application process will be returned. All applications, including resumes, must be submitted through HCSC's Career website on-line application process. If you have general questions regarding the status of an existing application, navigate to "candidate home" to view your job submissions. Legal and Privacy Health Care Service Corporation is an Equal Opportunity Employment / Affirmative Action employer Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of New Mexico, Blue Cross and Blue Shield of Oklahoma, and Blue Cross and Blue Shield of Texas, Divisions of Health Care Service Corporation, a Mutual Legal Reserve Company, and Independent Licensee of the Blue Cross and Blue Shield Association © Copyright 2022 Health Care Service Corporation. All Rights Reserved.
  • 24 Days Ago

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PBM / Managed Care Pharmacist
  • Pharmacy Careers
  • Albuquerque, NM FULL_TIME
  • We are currently seeking a skilled and motivated Pharmacist with expertise in Pharmacy Benefit Management (PBM) and Managed Care. In this pivotal role, you will be responsible for overseeing medicatio...
  • 1 Month Ago

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Market Director, Provider Relations & Outreach
  • Lovelace Health System, Inc.
  • Albuquerque, NM FULL_TIME
  • Overview Ardent Health Services is a leading provider of healthcare in communities across the country. Through its subsidiaries, Ardent owns and operates nearly 200 sites of care and 30 hospitals acro...
  • 1 Month Ago

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Provider representative
  • Health Care Service Corporation
  • Albuquerque, NM FULL_TIME
  • At HCSC, we consider our employees the cornerstone of our business and the foundation to our success. We enable employees to craft their career with curated development plans that set their learning p...
  • 18 Days Ago

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Customized Community Care Provider
  • The New Beginnings
  • Placitas, NM TEMPORARY,FULL_TIME,PART_TIME
  • 1000.00 Sign On Bonus after 6 months Of Employment Exciting and new opportunities to provide assistance to support adults in achieving their goals. These positions offer a rare opportunity to assist i...
  • Just Posted

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Personal Care Provider
  • Providence Support Services, Inc.
  • Albuquerque, NM FULL_TIME
  • $15.15 Hourly rate for Direct Care duties: 1)Thurs-Sunday Schedule Thurs/Fri 9:30am-7pm Sat 9 am-8pm, Sunday 9am-7pm 2)Sun- Wednesday Schedule Sun/Monday 9:00am-8:00pm, Tues/Wed 9:30am-7:30pm *Hiring ...
  • 1 Month Ago

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0 Managed Care Provider Relations Manager jobs found in Albuquerque, NM area

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TRAVEL NURSE RN - OR - $1,954 PER WEEK IN ALBUQUERQUE, NM
  • Mindlance Health
  • Albuquerque, NM
  • Most of our positions require at least 2 years of nursing experience, with an active RN license and BLS and/or ACLS (if ...
  • 4/24/2024 12:00:00 AM

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TRAVEL NURSE RN - PCU - $2,181 PER WEEK IN ALBUQUERQUE, NM
  • Mindlance Health
  • Albuquerque, NM
  • Most of our positions require at least 2 years of nursing experience, with an active RN license and BLS and/or ACLS (if ...
  • 4/24/2024 12:00:00 AM

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TRAVEL NURSE RN - TELEMETRY - $2,406 PER WEEK IN ALBUQUERQUE, NM
  • Mindlance Health
  • Albuquerque, NM
  • Most of our positions require at least 2 years of nursing experience, with an active RN license and BLS and/or ACLS (if ...
  • 4/24/2024 12:00:00 AM

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TRAVEL NURSE RN - PACU/PRE-POST OP - $2,078 PER WEEK IN ALBUQUERQUE, NM
  • Mindlance Health
  • Albuquerque, NM
  • Most of our positions require at least 2 years of nursing experience, with an active RN license and BLS and/or ACLS (if ...
  • 4/24/2024 12:00:00 AM

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Executive Director
  • Ambercare
  • Albuquerque, NM
  • Ambercare is looking for a full-time Executive Director to join our fast growing hospice team in the city of Albuquerque...
  • 4/23/2024 12:00:00 AM

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TRAVEL NURSE RN - MED/SURG - $1,954 PER WEEK IN ALBUQUERQUE, NM
  • Mindlance Health
  • Albuquerque, NM
  • Most of our positions require at least 2 years of nursing experience, with an active RN license and BLS and/or ACLS (if ...
  • 4/23/2024 12:00:00 AM

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Travel Cath Lab Technologist - $2,838 per week
  • TRS Healthcare
  • Albuquerque, NM
  • Springboard Healthcare is seeking a travel Cath Lab Technologist for a travel job in Albuquerque, New Mexico. Job Descri...
  • 4/22/2024 12:00:00 AM

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Restaurant Manager
  • BJ's Restaurants
  • Albuquerque, NM
  • Overview: Do you challenge yourself to always do things right and do them better? Then you will thrive at BJ’s Restauran...
  • 1/3/2024 12:00:00 AM

According to the United States Census Bureau, Albuquerque has a total area of 189.5 square miles (490.9 km2), of which 187.7 square miles (486.2 km2) is land and 1.8 square miles (4.7 km2), or 0.96%, is water. Albuquerque lies within the northern, upper edges of the Chihuahuan Desert ecoregion, based on long-term patterns of climate, associations of plants and wildlife, and landforms, including drainage patterns. Located in central New Mexico, the city also has noticeable influences from the adjacent Colorado Plateau semi-desert, Arizona-New Mexico Mountains, and Southwest plateaus and plains ...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Provider Relations Manager jobs
$94,844 to $136,814
Albuquerque, New Mexico area prices
were up 2.5% from a year ago

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