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)
Compass Medical Provider is looking for a Medical Care Coordinator to support the Minnesota Army National Guard.
Position Summary:
Care Coordinator personnel will be responsible for coordinating and monitoring of medical and dental treatment plans with soldiers for the National Guard.
Requirements listed below are representative of the knowledge, skill, and/or ability required to be employed for this position.
Administrative charting - Employee will ensure all administrative charting is completed and reviews are conducted monthly to ensure that every Soldier with a need is being tracked, managed, and communicated with at a minimum of every 30 days.
Assist Soldiers in scheduling appointments with appropriate facilities for a mass event and assist with the national voucher vendor.
Communicate with delegated government personnel to track compliance versus noncompliance.
Monitor designated medical readiness databases to ensure all scheduled services are completed/updated and current medical status is reflected.
Attend PHA events as determined by the needs of the state and the individual units.
Prepare for and/or document team case meetings as directed by the case management team and/or DSS and State Dental Officer
Follow the regulations and policies applicable to Individual Medical Readiness (IMR) and deployment
Maintain Soldier medical records in accordance with Army Regulation (AR) 40-66.
Obtain release of information from Soldier.
Maintain Health Insurance Portability and Accountability Act of1996 (HIPAA) standards and guidelines.
Upload medical/dental documents .
Provide all documents received for case management to SSO office
Obtain a working knowledge of Military dynamics and organizational management.
Minimum Experience:
6 years experience working in a healthcare setting. An ideal candidate would have some knowledge in healthcare and basic of dental practices.
Proven work experience as a team leader or supervisor.
Excellent communication, leadership, organizational and time-management skills.
Requirements
Security – Must be able to pass a national security background check for access into military electronic systems.
Possess the required technical skills and expertise to perform the above responsibilities with minimal guidance.
Must be proficient in Microsoft Word, Excel, PowerPoint, and Outlook, and have a working knowledge of desktop computer operations.
Prefer additionally:
Prior active duty or military contracting experience preferred
Must have experience working with confidential, detailed processes. Excellent organizational and customer service skills.
Compass Medical Provider takes great pride in assisting the National Guard with soldiers Health and Dental needs.
Job Types: Full-time, Contract
Pay: From $27.00 per hour
Expected hours: 40 per week
Benefits:
Schedule:
Work setting:
Experience:
Language:
Ability to Relocate:
Willingness to travel:
Work Location: In person
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0 Managed Care Provider Relations Manager jobs found in Minneapolis, MN area