Managed Care Provider Relations Manager jobs in Norfolk, VA

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)

V
Credential and Managed Care Coordinator
  • Virginia Oncology Associates
  • Norfolk, VA FULL_TIME
  • Overview:



    Virginia Oncology Associates, the largest group of medical professionals in Hampton Roads and Northeast North Carolina devoted exclusively to cancer care and blood disorders, has an exciting opportunity for a Credentialing Managed Care Coordinator for our office in Norfolk.

    ***Please take this quick survey once you've submitted your resume to complete the application process: Credential and Managed Care PI Survey
    Responsibilities:
    • Credentials and re-credentials providers according to quality standards and company policies and procedures. Notifies providers of licensure expirations and submits licensure applications and renewal forms with payment to State agencies and appropriate departments. Recommends process improvements.
    • Maintains current provider licensure files and provides information to hospitals and other healthcare providers as appropriate. Requests and completes hospital credentialing and privileges applications for providers.
    • Obtains and maintains provider participation in managed care plans in a timely manner and communicates information to practice sites and business office.
    • May implement and maintain the contract management system to include terms of the contract, providers credentialed to the payer and other contracted service providers (labs, hospitals).
    • May complete EOB analyses or fee schedule variance reporting on a monthly basis for the top Managed Care payers according to policy and procedure. May produce monthly managed care reports and implement new analysis tools to assist in reporting functions.
    • May maintain expected reimbursement by CPT code for the top payer contracts in each market and communicate changes to system librarian.
    • May develop and provide maintenance of proformas for all contracts.
    • Supports Network Contracting Representative/Manager in general administrative functions.
    • Trains junior and practice staff with respect to credentialing contracts, policies and procedures.
    • Other duties as requested or assigned.
    Qualifications:
    • High school diploma or equivalent required.
    • Technical certification or Associates Degree a plus.
    • At least five (5) years of credentialing related work experience required.
    • Proficiency with computer systems and Microsoft (Office Outlook, Word, Power Point, and Excel) required.
    • CPCS certification is preferred.
  • 11 Days Ago

T
Managed Care Coordinator - Foster Care
  • The Elevance Health Companies, Inc.
  • NORFOLK, VA OTHER
  • Anticipated End Date: 2024-06-03 Position Title: Managed Care Coordinator - Foster Care Job Description: The Foster Care Managed Case Manager is responsible for overall management of member's individu...
  • 1 Day Ago

E
Managed Care Coordinator - Foster Care
  • Elevance Health
  • Norfolk, VA FULL_TIME
  • Job Family: MED > Care Coord & Care Mgmt (Non-Licensed) Type: Date Posted: Apr 16, 2024 Anticipated End Date: May 20, 2024 Reference: JR113650 Description The Foster Care Managed Case Manager is respo...
  • 7 Days Ago

C
Childcare Provider
  • Coastal Child Care LLC
  • Norfolk, VA CONTRACTOR,PART_TIME,TEMPORARY,FULL_TIME
  • GET PAID SAME DAY! BABYSITTERS, NANNIES, TUTORS, PET SITTERS, AND MORE... Flexible schedules or fixed schedules!! Coastal Child Care has multiple openings we are searching to fill with the most qualif...
  • 20 Days Ago

C
Childcare Provider
  • Coastal Child Care LLC
  • Chesapeake, VA PART_TIME,FULL_TIME,TEMPORARY,CONTRACTOR
  • GET PAID SAME DAY! BABYSITTERS, NANNIES, TUTORS, PET SITTERS, AND MORE... Flexible schedules or fixed schedules!! Coastal Child Care has multiple openings we are searching to fill with the most qualif...
  • 20 Days Ago

C
Childcare Provider
  • Coastal Child Care LLC
  • Elizabeth, NC TEMPORARY,CONTRACTOR,FULL_TIME,PART_TIME
  • GET PAID SAME DAY! BABYSITTERS, NANNIES, TUTORS, PET SITTERS, AND MORE... Flexible schedules or fixed schedules!! Coastal Child Care has multiple openings we are searching to fill with the most qualif...
  • 13 Days Ago

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0 Managed Care Provider Relations Manager jobs found in Norfolk, VA area

According to the United States Census Bureau, the city has a total area of 96 square miles (250 km2), of which 54 square miles (140 km2) is land and 42 square miles (110 km2) (43.9%) is water. Norfolk is located at 36°55′N 76°12′W / 36.917°N 76.200°W / 36.917; -76.200 (36.8857° N, 76.2599° W) The city is located at the southeastern corner of Virginia at the junction of the Elizabeth River and the Chesapeake Bay. The Hampton Roads Metropolitan Statistical Area (officially known as the Virginia Beach-Norfolk-Newport News, VA-NC MSA) is the 37th largest in the United States, with an estimated...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Provider Relations Manager jobs
$95,046 to $137,105
Norfolk, Virginia area prices
were up 1.2% 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