Managed Care Provider Relations Manager jobs in Altoona, PA

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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Managed Care Specialist
  • UPMC
  • Altoona, PA FULL_TIME
  • Purpose:
    Answers all incoming phone calls in the test scheduling area and schedules all testing requested by physicians within the group practice for test orders. Coordinates patient care by required pre-certification

    Responsibilities:

    • Fax requests and letters to provider or facility performing test/procedure.
    • Understands roster management and can assist with it as assigned
    • Takes incoming calls and relays messages appropriately.
    • Ensure timely flow of information regarding managed care contacts and/or patients to specialists, primary care physicians, staff, and patients.
    • Gives patients complete information regarding any test or procedures being performed, including any preparation requirements.
    • Schedules diagnostic testing or procedures outside of for patients.
    • Pre-certifies patient services and obtains necessary approval of specialties, hospital admissions, emergency treatment, out-of-office testing, rehabilitation, DME, and any other necessary service.
    • Applies principles of specific managed care products to each task to ensure contractual compliance.
    • Updates patient chart with scheduled appointment date and time, prep, prints instructions if any.
    • Inform HIS Department if any information needs to be sent to the consulting physician's office.
    • Works with manager to maintain files, and coordinates patient care as it relates to quality assurance and utilization review.
    • Responds to documents and orders from physicians regarding the ordering of tests, procedures, and appointments with specialists per physician orders.
    • Keeps current with managed care products and how changes may affect them.
  • 22 Days Ago

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Child Care Provider
  • Crayon Castle Child Care Center
  • Brookville, PA FULL_TIME
  • Applicants must be ambitious and energetic, willing and able to work with children. Must be loving and compassionate and willing to work hard! We are seeking someone who is dependable and trustworthy....
  • 14 Days Ago

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Family Physician
  • Provider Openings
  • Punxsutawney, PA FULL_TIME
  • At The Primary Health Network, we believe that every person deserves access to high quality healthcare services regardless of race, color, national origin, age, disability, sex or ability to pay. We p...
  • 14 Days Ago

C
Social Work Case Manager
  • Caring Friends Home Care
  • State College, PA FULL_TIME
  • Intervention Associates is seeking PRN Case Managers and Social Workers to bring top-class services to the aging population in State College. Intervention Associates, part of the Houseworks family of ...
  • 19 Days Ago

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Dialysis Clinical Manager
  • Fresenius Medical Care
  • Du Bois, PA FULL_TIME
  • PURPOSE AND SCOPE: Supports FMCNA’s mission, vision, core values and customer service philosophy. Adheres to the FMCNA Compliance Program, including following all regulatory and FMS policy requirement...
  • 4 Days Ago

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Habilitation Manager
  • BAYADA Home Health Care at Bayhealth
  • State College, PA FULL_TIME
  • BAYADA Home Health Care has an immediate opening for a Habilitation Manager in our State College, PA office. If you are looking for an exciting career opportunity in a growing industry, a Habilitation...
  • 16 Days Ago

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0 Managed Care Provider Relations Manager jobs found in Altoona, PA area

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Territory Manager - Spanish Speaking Preferred
  • US Foods, Inc.
  • Greater Pittsburgh, PA
  • ESSENTIAL DUTIES AND RESPONSIBILITIES • Foster the customer relationship in a team based selling model. • Manage deliver...
  • 3/29/2024 12:00:00 AM

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Assistant in Training
  • Buckle
  • Altoona, PA
  • Summary Buckle is seeking experienced and talented individuals who desire to take their skills to the next level. As an ...
  • 3/29/2024 12:00:00 AM

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Part-Time Sales Teammate
  • Buckle
  • Altoona, PA
  • Summary At Buckle, we target enthusiastic, ambitious individuals, who enjoy fashion and possess strong communication ski...
  • 3/29/2024 12:00:00 AM

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Territory Manager - Altoona, PA
  • US Foods, Inc.
  • Altoona, PA
  • ESSENTIAL DUTIES AND RESPONSIBILITIES • Foster the customer relationship in a team based selling model. • Manage deliver...
  • 3/28/2024 12:00:00 AM

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Territory Manager Market Support
  • US Foods, Inc.
  • Greater Pittsburgh, PA
  • ESSENTIAL DUTIES AND RESPONSIBILITIES while covering for other Territory Managers: • Foster the customer relationship in...
  • 3/26/2024 12:00:00 AM

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Territory Manager Lancaster
  • US Foods, Inc.
  • Allentown, PA
  • ESSENTIAL DUTIES AND RESPONSIBILITIES • Foster the customer relationship in a team based selling model. • Manage deliver...
  • 3/25/2024 12:00:00 AM

T
Travel CT Technologist - $2,709 per week
  • TRS Healthcare
  • Altoona, PA
  • Springboard Healthcare is seeking a travel CT Technologist for a travel job in Altoona, Pennsylvania. Job Description & ...
  • 3/25/2024 12:00:00 AM

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Route Service Supervisor- UniFirst
  • UniFirst
  • Ebensburg, PA
  • Route Service Supervisor UniFirst is seeking a Route Service Supervisor to join our team! The Route Service Supervisor w...
  • 3/21/2024 12:00:00 AM

Altoona is a city in Blair County, Pennsylvania, United States. It is the principal city of the Altoona Metropolitan Statistical Area (MSA). The population was 46,320 at the time of the 2010 Census, making it the eleventh most populous city in Pennsylvania. The Altoona MSA includes all of Blair County and was recorded as having a population of 127,089 at the 2010 Census, around 100,000 of whom live within a 5-mile (8.0 km) radius of the Altoona city center according to U.S. Census ZIP Code population data. This includes the adjacent boroughs of Hollidaysburg and Duncansville, adjacent township...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Provider Relations Manager jobs
$93,802 to $135,316
Altoona, Pennsylvania area prices
were up 1.5% from a year ago

Managed Care Provider Relations Manager in Atlantic City, NJ
No industry wants to be called inflexible, incompetent, arrogant, greedy, unresponsive, pushy, unethical, or careless, but that's how hospitals and physician groups described managed care companies in a recent survey.
February 11, 2020
Managed Care Provider Relations Manager in Fort Wayne, IN
Brandon Edwards, the head of Davies' healthcare division, says providers would prefer better relationships with payers.
January 08, 2020
Managed Care Provider Relations Manager in Birmingham, AL
Providers "want legitimate, honest P4P programs, data exchange, streamlined business processes, and clarity.
November 28, 2019