Managed Care Provider Relations Manager jobs in Fresno, 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
  • Fresno, 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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Clinician - Managed Care (King County: $3000 Hiring Incentive)
  • Pacific Clinics a merger with Uplift Family...
  • Fresno, CA FULL_TIME
  • Title: Clinician - Managed Care (King County: $3000 Hiring Incentive and Up to $3000 Bilingual Incentive, Spanish Preferred)Actual offers will be determined by the candidate’s creditable years of expe...
  • 8 Days Ago

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Nurse Practitioner
  • Provider Healthcare
  • Le Grand, CA FULL_TIME
  • Job Type Full Time Schedule - Days Pay Depends on Experience Patients Per Day EMR System - Epic Work Location All Ages; Outpatient Job ID 60329 Job Description A Le Grand, California based client is s...
  • 28 Days Ago

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Dentist Needed Excellent Pay and Benefits Le Grand, California
  • Provider Healthcare
  • Le Grand, CA FULL_TIME
  • Job Type Full Time Schedule M-F 8-5 Pay Depends on Experience Patients Per Day 18-20 EMR System - Epic Work Location Clinic Job ID 60336 Job Description A Le Grand based client is searching for an exp...
  • 28 Days Ago

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Care Manager/ Care Navigator
  • Master•Care Inc
  • Bishop, CA FULL_TIME
  • Use your Experience to Truly Make a Difference! Join the Master•Care team as a Care Navigator!Master•Care, Inc. is a Managed Services Organization (MSO) created exclusively to bridge medical and non-m...
  • 6 Days Ago

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LABOR RELATIONS PROGRAM MANAGER
  • County of Fresno
  • Fresno, CA FULL_TIME
  • Position Description APPLY IMMEDIATELY AS THIS RECRUITMENT MAY CLOSE AT ANY TIMEAPPLICATIONS MUST BE SUBMITTED ONLINE ONLYThe Fresno County Department of Human Resources is offering an outstanding car...
  • 27 Days Ago

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

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Principal Architect
  • Korn Ferry
  • Fresno, CA
  • Principal / Client Executive We are partnering with a client that has been at the forefront of architectural and enginee...
  • 4/24/2024 12:00:00 AM

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

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TRAVEL NURSE RN - LABOR/DELIVERY - $1,772 PER WEEK IN FRESNO, CA
  • Mindlance Health
  • Fresno, CA
  • 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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Inside Sales Associate II
  • Resideo Technologies, Inc.
  • Fresno, CA
  • ADI, part of Resideo Inc, is North America's leading wholesale distributor of security and low-voltage. We are passionat...
  • 4/24/2024 12:00:00 AM

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Area Directors of Sales -Hotels
  • SETHI MANAGEMENT, INC
  • Fresno, CA
  • Company Description Sethi Management, Inc. is a leading service provider in the industry. Our team of hand-picked experi...
  • 4/23/2024 12:00:00 AM

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TRAVEL NURSE RN - ER/TRAUMA - $2,191 PER WEEK IN FRESNO, CA
  • Mindlance Health
  • Fresno, CA
  • 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 Ultrasound Technologist - $4,334 per week
  • Hiring Now!
  • Madera, CA
  • Springboard Healthcare is seeking a travel Ultrasound Technologist for a travel job in Madera, California. Job Descripti...
  • 4/22/2024 12:00:00 AM

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TeleSales Representative - Remote
  • InsuraTec Services Group
  • Fresno, CA
  • TeleSales Representative- Remote Job Description: Are you a self-motivated, driven individual with a passion for sales a...
  • 4/21/2024 12:00:00 AM

Fresno (/ˈfrɛznoʊ/ FREZ-noh; Spanish for "ash tree") is a city in California, United States, and the county seat of Fresno County. It covers about 112 square miles (290 km2) in the center of the San Joaquin Valley, the southern portion of California's Central Valley. Named for the abundant ash trees lining the San Joaquin River, Fresno was founded in 1872 as a railway station of the Central Pacific Railroad before it was incorporated in 1885. The city has since become an economic hub of Fresno County and the San Joaquin Valley, with much of the surrounding areas in the Metropolitan Fresno regi...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Provider Relations Manager jobs
$101,100 to $145,838
Fresno, California area prices
were up 2.7% from a year ago

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