Managed Care Provider Relations Manager jobs in Bakersfield, CA

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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PBM / Managed Care Pharmacist
  • Pharmacy Careers
  • Bakersfield, CA 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 medication utilization, formulary management, and ensuring cost-effective pharmacy services. The ideal candidate will bring a deep understanding of managed care principles, a proactive approach to problem-solving, and a commitment to optimizing pharmacy outcomes within a managed care environment.

    Preferred Qualifications:
    PharmD degree from an accredited pharmacy program
    Previous experience in Pharmacy Benefit Management (PBM) or Managed Care
    Knowledge of formulary development and management
    State pharmacy license in good standing
    Strong analytical and data interpretation skills
    Excellent communication and negotiation abilities
    Familiarity with healthcare regulations and compliance standards
    Collaboration experience with healthcare providers, payers, and pharmaceutical manufacturers
    Proficiency in utilizing pharmacy management software and tools
    Active participation in relevant professional organizations
    Dedication to staying informed about industry trends and innovations

    Responsibilities:
    Collaborate with healthcare stakeholders to implement and optimize pharmacy benefit programs
    Conduct formulary reviews and assessments to ensure cost-effective and evidence-based medication choices
    Monitor and analyze pharmacy utilization trends, identifying opportunities for cost savings and improved patient outcomes
    Provide expertise in drug utilization management and prior authorization processes
    Stay informed about industry regulations, guidelines, and emerging trends in managed care pharmacy
    If you are a passionate and experienced pharmacist with a background in PBM or Managed Care, we invite you to join our dynamic team dedicated to advancing healthcare through innovative and cost-effective pharmacy solutions. Apply now to contribute to the future of managed care pharmacy.
  • 1 Month Ago

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Manager, Community Relations & Marketing
  • Bakersfield Condors
  • Bakersfield, CA FULL_TIME
  • About OEG Sports & Entertainment: OEG Sports & Entertainment delivers North America’s leading sports and entertainment experiences to connect our fans to their passions. Located in the heart of the IC...
  • 17 Days Ago

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Manager, Community Relations & Marketing
  • Oilers Entertainment Group
  • Bakersfield, CA FULL_TIME
  • About OEG Sports & Entertainment: OEG Sports & Entertainment delivers North America’s leading sports and entertainment experiences to connect our fans to their passions. Located in the heart of the IC...
  • 17 Days Ago

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Manager, Community Relations & Marketing
  • OILERS ENTERTAINMENT GROUP STYLE 1
  • Bakersfield, CA FULL_TIME
  • About OEG Sports & Entertainment: OEG Sports & Entertainment delivers North America’s leading sports and entertainment experiences to connect our fans to their passions. Located in the heart of the IC...
  • 22 Days Ago

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Manager, Community Relations & Digital Media
  • Oilers Entertainment Group
  • Bakersfield, CA FULL_TIME
  • POSITION TITLE: Manager, Community Relations & Digital Media Role Summary: As part of the team’s marketing department, the Manager, Community Relations & Digital Media will primarily oversee the team’...
  • 22 Days Ago

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Pharmacy Technician
  • HERITAGE PROVIDER NETWORK
  • Bakersfield, CA FULL_TIME
  • Essential Duties and Responsibilities include the following: Assist the pharmacist in the following areas while under the Pharmacist’s supervision:• Verification of health care insurance for non-cover...
  • 8 Days Ago

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0 Managed Care Provider Relations Manager jobs found in Bakersfield, CA area

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Sales Executive
  • City Lifestyle
  • Bakersfield, CA
  • Join the City Lifestyle Team as a Sales Executive City Lifestyle, formerly known as Lifestyle Publications, has been a p...
  • 4/26/2024 12:00:00 AM

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SPECIAL EVENTS COORDINATOR
  • Dolores Huerta Foundation
  • Bakersfield, CA
  • Job Description Job Description The Organization: The Dolores Huerta Foundation (DHF) is a growing 501(c)(3) non-profit ...
  • 4/26/2024 12:00:00 AM

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TeleSales Representative - Remote
  • InsuraTec Services Group
  • Delano, CA
  • TeleSales Representative- Remote Job Description: Are you a self-motivated, driven individual with a passion for sales a...
  • 4/25/2024 12:00:00 AM

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Refrigeration Manager
  • Bolthouse Farms
  • Bakersfield, CA
  • THE ROLE: This position will report to the: Maintenance Director Location: Bakersfield, CA FLSA Status: Exempt Employmen...
  • 4/25/2024 12:00:00 AM

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Client Relationship Manager
  • Ernest
  • Bakersfield, CA
  • Ernest is currently in search of a Client Relationship Manager (outside B2B sales) for our division located in Bakersfie...
  • 4/24/2024 12:00:00 AM

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Business Developer SLED
  • Staples Inc.
  • Bakersfield, CA
  • Staples is business to business. Youre what binds us together. Prospects within defined territory to pursue two main res...
  • 4/23/2024 12:00:00 AM

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Refrigeration Manager
  • Bolthouse Farms
  • Bakersfield, CA
  • THE ROLE: This position will report to the: Maintenance Director Location Bakersfield, CA FLSA Status: Exempt Employment...
  • 4/23/2024 12:00:00 AM

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Business Developer SLED
  • Staples, Inc.
  • Bakersfield, CA
  • Staples is business to business. Youre what binds us together. Prospects within defined territory to pursue two main res...
  • 4/22/2024 12:00:00 AM

Bakersfield is a city in and the county seat of Kern County, California, United States. It covers about 151 sq mi (390 km2) near the southern end of the San Joaquin Valley and the Central Valley region. Bakersfield's population is around 380,000, making it the 9th-most populous city in California and the 52nd-most populous city in the nation. The Bakersfield–Delano Metropolitan Statistical Area, which includes all of Kern County, had a 2010 census population of 839,631, making it the 62nd-largest metropolitan area in the United States. The more built-up urban area that includes Bakersfield and...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Provider Relations Manager jobs
$107,053 to $154,425
Bakersfield, California area prices
were up 2.5% 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