Managed Care Provider Relations Manager jobs in Ogden, UT

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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Case Manager - Managed Care
  • Weber Human Services
  • Ogden, UT FULL_TIME
  • Job Description:


    Help coordinate mental health, medical, substance abuse services and social service needs of the adult mental health clients.

    Ensure clients have needed resources by linking, assisting and coordinating.

    Meet with each client individually and set meetings between them and all of the care team members.

    Document services in each clients’ chart.

    Respond to alerts received about each client.

    Check to ensure each client has necessary medication.

    Coordinate with the clients’ treatment team, the inpatient hospital and residential staff regarding client needs.


    Experience and Skills:

    Would prefer a Bachelor's Degree but would interview a Graduate from high school or GED

    AND twelve (12) months of supervised practice/experience in completion of a practicum working with mentally ill adults or some other social service program OR Equivalent combination of education and related experience.


    Job Benefits:

    Weber Human Services

    Benefit Package Overview

    July 1, 2023 – June 30, 2024

    • Your Benefit Package can include 40-100% of wage depending on what options are chosen.

    Eligibility:

    You are eligible to enroll for benefits if you are a full-time employee working 30 or more hours per week. (Rates are on a sliding scale for employees that work under 40 hours a week).

    HEALTH INSURANCE

    PEHP (Effective on the first day following the month that the employee is hired)

    Coverage is offered to the employee, spouse and children under age 26. Advantage Star includes IHC Network; Summit Star includes Ogden Regional Network. (Rates are deducted twice monthly through payroll deduction.)

    High Deductible STAR 1HSA Contribution

    Single Coverage: $56.20 (WHS pays $637.18 monthly toward your premium)

    2 Party Coverage: $154.42 (WHS pays $1235.38 monthly toward your premium)

    Family Coverage: $230.88 (WHS pays $1637.18monthly toward your premium

    Single Coverage: $32.67 contributed to your account twice a month

    2 Party Coverage: $74.25 contributed to your account twice a month

    Family Coverage: $89.29 contributed to your account twice a month


    Below represents using an in-network provider:

    Preventive Services are covered at 100%

    Fiscal year deductibles: $1,500 Single; $3,000 2 Party; $3,000 Family

    Employee pays all deductibles. Once the deductible is satisfied, employee pays 20% up to $3000 for single, and $6000 for double or family.

    High Deductible STAR 2HSA Contribution

    Single Coverage: $49.37 (WHS pays $559.54 monthly toward your premium)

    2 Party Coverage: $135.61 (WHS pays $1084.84 monthly toward your premium)

    Family Coverage: $202.75 (WHS pays $1437.70 monthly toward your premium

    Single Coverage: $68.58 contributed to your account twice a month

    2 Party Coverage: $138.88 contributed to your account twice a month

    Family Coverage: $174.96 contributed to your account twice a month


    Below represents using an in-network provider:

    Preventive Services are covered at 100%

    Fiscal year deductibles: $3,000 Single; $6,000 2 Party; $6/000 Family

    Employee pays all deductibles. Once the deductible is satisfied, employee pays 20% up to $6000 for single, and $12,000 for double or family.

    Traditional Plan - Advantage Star includes IHC Network; Summit Star includes Ogden Regional Network. (Rates are deducted twice monthly through payroll deduction.)

    Single Coverage $77.93 (WHS pays $623.40 monthly toward your premium)

    2 Party Coverage $184.61 (WHS pays $1236.06 monthly toward your premium)

    Family Coverage $272.74 (WHS pays $1636.06monthly toward your premium)

    Below represents using an in-network provider:

    Preventive Services are covered at 100%

    Fiscal year deductibles: $1500 Single; $3,000 Double; $3,000 Family

    Primary Care Provider - $30 (deductible waived)

    Specialist Provider - $40 (deductible waived)

    Urgent Care - $50 (deductible waived)

    Emergency Room - $500

    Impatient Services: Medical, Surgical, Hospice and Emergency Admissions – 30% after deductible

    Prescriptions: 20% for Tier A; 30% for Tier B

    Autism Spectrum Disorder Benefit

    Covers children ages 2-9 years of age, up to 600 hours per year of behavioral health treatment. Requires mental health services preauthorization through PEHP.

    Ability to Waive Coverage upon proof of other medical coverage

    Employees hired to work 40 hours per week may waive medical coverage and in lieu choose:

    $287.72 deposited per biweekly pay period into their 401(k) or 457 plan;

    OR

    $143.86 paid per biweekly pay period as taxable income. The amounts paid are on a sliding scale for those working less than 40 hours per week. (Proof of other medical insurance coverage must be provided to choose these options.)

    NICE HEALTHCARE

    NICE is an integrated primary care clinic that brings FREE medical visits, medications, labs, imaging, physical therapy and mental health therapy to you. Nice’s in-home and virtual visits come with no out-of-pocket costs, as so all services included in your treatment plan.

    • Features same day chat and video visits
    • Primary care for wellness, acute and chronic conditions
    • In-home visits with 35 FREE labs and Physical Tests
    • 550 Free Medications can be prescribed by physicians
    • Virtual Physical Therapy visits
    • Virtual Mental Health Therapy visits
    • In-home X-rays an EKG services

    DENTAL INSURANCE

    Dental Select (Effective on the first day following the month that the employee is hired)

    Coverage is offered to the employee, spouse and children under age of 26.

    Employee may waive medical coverage and carry dental coverage only. No compensation shall be made for waiving dental coverage. Rates are semi-monthly through payroll deduction:

    Single Coverage: $5.24

    2 Party Coverage: $7.17

    Family Coverage: $10.86

    Below represents using an in-network provider:

    Preventive: Cleanings, routine exams, x-rays, topical fluoride (2 per fiscal year) – 100%

    Basic; Fillings, extractions, oral surgery, endodontics – 80%

    Major: Crowns, bridges, dentures and periodontics – 50%

    Orthodontics – Children and Adults – 50% of eligible fees to plan maximum ($1,500 maximum lifetime benefit per member

    Deductible – Applies to basic and major services – $25 per individual and $75 family maximum

    VISION INSURANCE

    EyeMed (Effective on the first day following the month that the employee is hired)

    Rates are semi-monthly through payroll deduction

    Single Coverage: $2.68

    2 Party Coverage $5.25

    Family Coverage: $6.95

    Below represents using an in-network provider:

    No examination benefit

    Lenses – Standard plastic; $10 co-pay

    Frames – Allowance based on retail pricing - $120 allowance

    Contacts – Benefits is in lieu of lens and frame benefit - $120 allowance (additional contact purchases are at retail prices)

    Frequency – Every 12 months

    LASIK – 15% off retail price or 5% of promotional price

    LIFE INSURANCE

    Basic Life Insurance – Hartford: (Effective on the first day following the month that the employee is hired)

    Weber Human Services provides $25,000 basic life insurance through Hartford Life Insurance at no cost to the employee.

    Supplemental Term Life Insurance - Hartford: (Effective upon approval from Hartford Life Insurance)

    An employee may purchase supplemental term life insurance for themselves, their spouse and children at various costs based on age and the amount of insurance desired through payroll deduction.

    SHORT TERM DISABILITY

    Optional plan for employees. Premium is based on pay, and can help protect your paycheck up to 60% for back injury, pregnancy, or serious illness that can lead to months without a regular paycheck.

    SUPPLEMENTAL ALLSTATE

    Allstate Supplemental Insurance: (Effective upon approval from Allstate)

    A supplemental insurance plan offered through payroll deduction. Plans offered are Critical Illness and Accident.

    FLEX SPENDING ACCOUNT

    Cafeteria Plan – National Benefits Services Reimbursement Account: (Effective on the first day following the month that the employee is hired)

    The health care reimbursement allows the employee to set aside up to $3,050 in pretax dollars to pay eligible out of pocket medical, dental, vision, prescriptions and non-prescription expenses through payroll deduction.

    The dependent care reimbursement allows you to set aside up to $5,000 in pretax dollars to pay for eligible dependent care expenses through payroll deduction.

    EMPLOYEE ASSISTANCE PROGRAM

    Guidance Resources Program – SUPPORTLINC

    Guidance Resources is a no-cost, company sponsored benefit that is available to you and your dependents to provide confidential support, resources and information to get through life’s challenges. Confidential counseling on personal issues; legal information; resources and consultation; financial information; resources and tools; online information, tools and services.

    PAID LEAVE

    Paid Leave – Holiday, Sick, Vacation: (Effective the first pay period after hire date)

    Holidays – 12 per calendar year

    Sick – 4 hours earned per biweekly pay period. 104 hours per calendar year

    Vacation:

    0 through 5 years: 4 hours earned per biweekly pay period = 104 hours per calendar year.

    6 years through 10 years: 5 hours earned per biweekly pay period = 130 hours per calendar year.

    11 years through 15 years: 6 hours earned per biweekly pay period = 156 hours per calendar year.

    16 years plus: 6.5 hours earned per biweekly pay period = 169 hours per calendar year.

    UTAH RETIREMENT

    Utah Retirement Systems: (Effective on date of hire)

    Tier 1 – Employees hired before July 1, 2011, or newly hired employees who are transferring from another agency under Utah Retirement Systems. You must be employed at least 4 years with Weber Human Services, or a combination of Weber Human Services and another state agency, in order to be vested to receive your pension plan at retirement age. Weber Human Services contributes 18.47% per biweekly pay period towards URS pension plan.

    Tier 2 – Employees hired after July 1, 2011. Weber Human Services contributes an amount equal to 10% of your salary between both plans: pension and 401(k). Pension contributions are based on the yearly pension contribution rate. Pension and employer contributions to your 401(k) are vested after four years.

    The following applies to both Tier 1 and Tier 2 retirement systems:

    An employee may also contribute through payroll deduction to a 401(k), 457, Roth or Traditional IRA.

    Weber Human Services will also match up to 1% of employee contribution towards 401(k)

    Upon termination, all money vested into your 401(k) becomes property of the employee.

    From: Weber Human Services

  • Just Posted

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Vendor Managed Inventory Specialist
  • MSC Industrial Supply Co.
  • Ogden, UT FULL_TIME
  • Build a better career with MSC. Serving customer and community starts with the very best people doing their very best work. That is precisely what we have at MSC Industrial Supply Co., a leading North...
  • 7 Days Ago

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Full Time Provider Services Practice Manager
  • Symbii Home Health & Hospice
  • Layton, UT FULL_TIME
  • ** * Provider Services Practice Manager *** $20.00-$26.00 Per Hour - Depending on Experience Job Overview:We are seeking a highly organized and experienced Practice Manager to oversee the daily operat...
  • 8 Days Ago

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Market Development Representative - Managed Services
  • Grant Victor
  • Kaysville, UT FULL_TIME
  • Company OverviewGrant Victor was been named, for 10 years running, as one of the Best Companies to Work For by Utah Business Magazine. As a rapidly growing company, Grant Victor, along with its subsid...
  • 18 Days Ago

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Senior Program Manager, Dialyzers
  • Fresenius Medical Care
  • Ogden, UT FULL_TIME
  • PURPOSE AND SCOPE: Responsible for providing comprehensive planning, execution, and overall leadership of one or more medium to large-scale initiatives. Duties also includes participating in the conti...
  • 3 Days Ago

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Account Manager Personal Care
  • brenntag
  • Ogden, UT FULL_TIME
  • Job Summary:Account Managers are responsible for managing the overall sales efforts in their assigned territory to maximize sales and profit. They must utilize frequent face-to-face and/or telephone c...
  • 6 Days Ago

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0 Managed Care Provider Relations Manager jobs found in Ogden, UT area

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Client Relationship Manager
  • Ernest
  • Salt Lake City, UT
  • Ernest is currently in search of a Client Relationship Manager (outside B2B sales) for our division located in Salt Lake...
  • 3/28/2024 12:00:00 AM

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Client Relationship Manager
  • Ernest
  • Salt Lake City, UT
  • Ernest Packaging Solutions is currently in search of a Client Relationship Manager for our division located in Salt Lake...
  • 3/28/2024 12:00:00 AM

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Sales Professional/ Business Owner
  • City Lifestyle
  • Ogden, UT
  • Join the City Lifestyle Team as a Business Owner City Lifestyle, formerly known as Lifestyle Publications, has been a po...
  • 3/28/2024 12:00:00 AM

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Appointment Setter 20/hr + Commission
  • PLATINUM SOLAR
  • Ogden, UT
  • Appointment Setter (Canvasser) (Platinum Solar, Northern Utah) Job Details : Salary : $5000-$10,000 / Month Avg. $500 Pe...
  • 3/28/2024 12:00:00 AM

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Sales Professional/ Business Owner
  • City Lifestyle
  • Syracuse, UT
  • Join the City Lifestyle Team as a Business Owner City Lifestyle, formerly known as Lifestyle Publications, has been a po...
  • 3/28/2024 12:00:00 AM

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Sales Professional/ Business Owner
  • City Lifestyle
  • Kaysville, UT
  • Join the City Lifestyle Team as a Business Owner City Lifestyle, formerly known as Lifestyle Publications, has been a po...
  • 3/28/2024 12:00:00 AM

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Outside Sales Representative
  • Ernest
  • Salt Lake City, UT
  • Ernest is currently in search of a Client Relationship Manager (Outside B2B Sales Rep) for our division located in Salt ...
  • 3/25/2024 12:00:00 AM

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Appointment Setter 20/hr +Commission
  • PLATINUM SOLAR
  • Ogden, UT
  • Appointment Setter (Canvasser) (Platinum Solar, Northern Utah) Job Details : Salary : $5000-$10,000 / Month Avg. $500 Pe...
  • 3/24/2024 12:00:00 AM

Ogden /ˈɒɡdən/ is a city and the county seat of Weber County, Utah, United States, approximately 10 miles (16 km) east of the Great Salt Lake and 40 miles (64 km) north of Salt Lake City. The population was 84,316 in 2014, according to the US Census Bureau, making it Utah's 7th largest city. The city served as a major railway hub through much of its history, and still handles a great deal of freight rail traffic which makes it a convenient location for manufacturing and commerce. Ogden is also known for its many historic buildings, proximity to the Wasatch Mountains, and as the location of Web...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Provider Relations Manager jobs
$93,238 to $134,503
Ogden, Utah area prices
were up 2.3% from a year ago

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