Managed Care Provider Relations Manager jobs in Los Angeles, 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)

3
Manager Provider Data Management – Managed Care - (LA8996)
  • 3 Key Consulting
  • Los Angeles, CA FULL_TIME
  • Job Title:  Manager Provider Data Management – Managed Care - (LA8996)
    Location: Los Angeles, CA. 90017
    Duration: 3 months with possible extensions OR conversion to permanent
    Business Unit: Provider Data Management
    Employment Type:  Contract
    Posting Date: 02/16/2023
    Notes: Only qualified candidates need apply.

    3 Key Consulting is recruiting a Manager Provider Data Management for a consulting engagement with our direct client, a leading global biopharmaceutical company.

    Job Description:
    The Manager of Provider Data Services provides leadership, supervision, and direction to support the operation and analytic functions of Provider Data Services unit's daily operations, including developing and applying departmental strategies; co-leads or leads enterprise-wide data management initiatives. The Manager participates as a liaison between client and its external and internal business partners to support business imperatives and data analysis and to drive positive business outcomes. 

     This position supports client’s leadership's strategy and drives the execution and operation of:
    • Provider Network Management.
    • Provider Data Management.
    • Medi-Cal Business partner’s Account Management team.

    Through a systematic and disciplined approach, the Manager oversees and manages technical deliverables to ensure data production and processing meets the enterprise's specifications, furthermore the Manager will work strategically with client’s leadership to provide analytical information in support of the organization's strategic goals.  

    The Manager, Provider Data Services has a strong knowledge of the healthcare market and technical capacity to ensure alignment of health plan operation, policies, regulatory requirements and implementation of IT data analytical services. 

    Top Must Have Skill Sets:
    • 5-7 years of direct experience developing complex data processing tasks
    • 3 years health care experience
    • 3 years of progressive Supervisory experience

    Day to Day Responsibilities:
    • Ability to understand business needs and translate those needs into specific requirements in both accurate business and technical terminologies based on the audience.
    • Excellent analytical thinking and ability to perform root cause analysis.
    • Drives work progress through strong leadership skills and ability to leverage healthcare and IT knowledge to drive outcomes.
    • Ability to plan for and articulate decision impacts across business processes and applications.   Perform other duties as assigned.

    Basic Qualifications:
    • Bachelor's Degree in Information Systems or Related Field In lieu of degree, equivalent education and/or experience may be considered.
    • 5-7 years of direct experience developing complex data processing tasks - ETL, data manipulation, and data build in RDBMS with multi-millions to billions’ data records (1 TB data volume).  
    • 5-7 years of data quality management and data analytical experience.
    • 3-5 years of healthcare experience.
    • 3-4 years of progressive supervision and management experience.
    • 3 years of IT application end-to-end (raw data to UI) development work experience.
    • 2 years of data modeling experience. 
    • 2 years of project/program management experience. 
    • 2 years of BPM and business process improvement experience.
    • Experience on BI tools.
    • Experience on NoSQL environment.  

    Preferred Qualifications:
    • Master's Degree in Information Systems or Related Field
    • Experience working with managing programs or other managerial experience.
    • Managed care experience.
    • Data management experience in Master Data Management (MDM) - data model and business rules.
    • Experience of vendor management (software and workforce) experience.
    • Experience of procurement management in contract negotiation, Request of Proposal (RFP), Master Service Agreement (MSA), Statement of Work (SOW) creation.
    • Data management experience in Master Data Management (MDM) - data model and business rule.

    Interview Process:
    First interview with Director and second with team

    We invite qualified candidates to send your resume to resumes@3keyconsulting.com.  If you decide that you’re not interested in pursuing this particular position, please feel free to take a look at the other positions on our website www.3keyconsulting.com/careers. You are also welcome to share this opportunity with anyone you think might be interested in applying for this role.
  • 18 Days Ago

U
Managed Care Contracts Manager
  • UCLA Health Careers
  • Los Angeles, CA FULL_TIME
  • DescriptionTake on a key leadership role within a world-class health organization. Help ensure the consistent delivery of exceptional patient care. Take your professional expertise to the next level. ...
  • 6 Days Ago

A
Manager - Provider Relations
  • Astrana Health
  • El Monte, CA FULL_TIME
  • Job Title: Manager - Provider Relations Department: Provider Relations Department About the Role: We are currently seeking a highly motivated Provider Relations Manager. This role will report to our D...
  • 1 Month Ago

P
Adult Primary Care Physician
  • Provider Solutions & Development
  • Mission Hills, CA OTHER
  • Provider Solutions & Development
  • 1 Month Ago

R
Director of Managed Care Contracts
  • Rockport Healthcare Services
  • Los Angeles, CA FULL_TIME
  • SUMMARY: The Director of Managed Care Contracts is responsible for the management of all managed care and capitation contracts/amendments, including, but not limited to, professional and facility fee ...
  • 9 Days Ago

E
Managed Care Collector
  • Ethos Management (Servicing AHMC Hospitals)
  • Alhambra, CA FULL_TIME
  • Overview: Ethos Management, Inc provides Collections, Billing, Accounts Receivable and Customer Service support to AHMC Hospitals to assist with their revenue cycle objectives. The Managed Care Collec...
  • 13 Days Ago

Filters

Clear All

Filter Jobs By Location
  • Filter Jobs by companies
  • More

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

B
Client Relationship Manager
  • Beverly Hills Private Wealth
  • Beverly Hills, CA
  • Client Relationship Manager Position Beverly Hills Private Wealth is an SEC registered investment advisory firm located ...
  • 4/26/2024 12:00:00 AM

G
Corporate Relationship Manager
  • Genesis Capital
  • Los Angeles, CA
  • Job Description Job Description The Corporate Relationship Manager is responsible for driving loan originations by manag...
  • 4/26/2024 12:00:00 AM

B
Business Banking Relationship Manager
  • BMO Financial Group
  • Monterey Park, CA
  • Come join a culture that is about so much more than the bottom line. Be a part of a team that celebrates big ideas, supp...
  • 4/25/2024 12:00:00 AM

E
Client Relationship Manager
  • Ernest Packaging Solutions
  • Los Angeles, CA
  • For over 77 years, Ernest has been committed to the success of our extended family, our customers, our employees, and th...
  • 4/24/2024 12:00:00 AM

C
Relationship Manager I -Virtual Concierge
  • City National Bank
  • Los Angeles, CA
  • **RELATIONSHIP MANAGER I -VIRTUAL CONCIERGE** **WHAT IS THE OPPORTUNITY?** Responsible for managing a portfolio of busin...
  • 4/24/2024 12:00:00 AM

E
Relationship Manager
  • EBizCharge
  • Irvine, CA
  • Headquartered in Irvine, California, EBizCharge specializes in developing payment processing applications that facilitat...
  • 4/23/2024 12:00:00 AM

1
Senior Relationships Manager, Social Media
  • 1000heads
  • Los Angeles, CA
  • The 1000heads Relationships team is a proud, powerful collective of Social Media obsessives, experts managing influencer...
  • 4/23/2024 12:00:00 AM

B
Client Relationship Manager - Wealth Management
  • BGSS
  • Los Angeles, CA
  • Job Description Job Description This Forbes Top 100 nationally ranked investment advisory firm with over $4.7B in AUM is...
  • 4/22/2024 12:00:00 AM

Los Angeles (/lɔːs ˈændʒələs/ (listen);[a] Spanish: Los Ángeles), officially the City of Los Angeles and often known by its initials L.A., is the most populous city in California, the second most populous city in the United States, after New York City, and the third most populous city in North America. With an estimated population of four million, Los Angeles is the cultural, financial, and commercial center of Southern California. The city is known for its Mediterranean climate, ethnic diversity, Hollywood and the entertainment industry, and its sprawling metropolis. Los Angeles is the larges...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Provider Relations Manager jobs
$112,400 to $162,139
Los Angeles, California area prices
were up 3.2% 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