Managed Care Provider Relations Manager jobs in Omaha, NE

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
  • Omaha, NE 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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Infant Child Care Provider
  • Salem Little Saints Christian Child Care Center
  • Fremont, NE FULL_TIME
  • Applicant would be responsible for the care of children 6 weeks to 1 year of age. Applicant Must be at least 19 years of age. Skills needed for this position: Working well with others Multitasking Exc...
  • Just Posted

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Toddler Child Care Provider
  • Salem Little Saints Christian Child Care Center
  • Fremont, NE FULL_TIME
  • Apply on-line Now Position Description Applicant would be responsible for the care of children 18 months to 2 years old. Applicant Must be at least 18 years of age. Previous experience required.Skills...
  • 7 Days Ago

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Afternoon Child Care Provider
  • Salem Little Saints Christian Child Care Center
  • Fremont, NE FULL_TIME
  • Apply on-line Now Position Description Applicant must be 18 years or older and previous experience preferred.Skills needed for this position:Working well with othersMultitaskingExcellent communication...
  • 30 Days Ago

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Preschool Child Care Provider
  • Salem Little Saints Christian Child Care Center
  • Fremont, NE FULL_TIME
  • Apply on-line Now Position Description Applicant would be responsible for the care of children who are 3 years old. Applicant Must be at least 18 years of age. Previous experience required.Skills need...
  • 1 Month Ago

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Provider Support Nurse
  • Angels Care Home Health
  • Omaha, NE FULL_TIME
  • Provider Support Nurse (RN) Angels Care Home Health is NOW HIRING a Provider Support Nurse to join our growing team in Nebraska. The provider support nurse will cover 3 locations surrounding Omaha, NE...
  • 1 Month Ago

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0 Managed Care Provider Relations Manager jobs found in Omaha, NE area

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Field Marketing Analyst
  • Accel Entertainment
  • Omaha, NE
  • ABOUT ACCEL ENTERTAINMENT Accel Entertainment is the largest Gaming Terminal Operator in the country. We provide slot ma...
  • 4/25/2024 12:00:00 AM

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Financial Planner
  • Creative Planning
  • Omaha, NE
  • The Financial Planner is responsible for the last five of six steps in the CFP Boards Financial Planning Process. This i...
  • 4/25/2024 12:00:00 AM

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Financial Planner
  • Creative Planning
  • Omaha, NE
  • The Financial Planner is responsible for the last five of six steps in the CFP Board’s Financial Planning Process. This ...
  • 4/25/2024 12:00:00 AM

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Market Sales Manager - Omaha, NE
  • BLC BACKLOTCARS Inc
  • Omaha, NE
  • Who We Are: At OPENLANE we make wholesale easy so our customers can be more successful. We’re a technology company build...
  • 4/24/2024 12:00:00 AM

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TRAVEL NURSE RN - REHAB - $2,605 PER WEEK IN OMAHA, NE
  • Mindlance Health
  • Omaha, NE
  • 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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TRAVEL NURSE RN - PCU - $2,153 PER WEEK IN OMAHA, NE
  • Mindlance Health
  • Omaha, NE
  • 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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Sr. Client Relationship Manager (DCCG - Habermann - Omaha, NE)
  • Usi Insurance Services
  • Omaha, NE
  • General Description: Responsible for work product and management of assigned Client Relationship team members. Provide d...
  • 4/23/2024 12:00:00 AM

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Marketing Manager (Field)
  • Accel Entertainment
  • Omaha, NE
  • ABOUT ACCEL ENTERTAINMENT Accel Entertainment is the largest Gaming Terminal Operator in the country. We provide slot ma...
  • 4/22/2024 12:00:00 AM

Omaha (/ˈoʊməhɑː/ OH-mə-hah) is the largest city in the state of Nebraska and the county seat of Douglas County. Omaha is located in the Midwestern United States on the Missouri River, about 10 miles (15 km) north of the mouth of the Platte River. The nation's 40th-largest city, Omaha's 2018 estimated population was 466,061. Omaha is the anchor of the eight-county, bi-state Omaha-Council Bluffs metropolitan area. The Omaha Metropolitan Area is the 59th largest in the United States, with an estimated population of 944,316 (2018). The Omaha-Council Bluffs-Fremont, NE-IA Combined Statistical Are...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Provider Relations Manager jobs
$95,954 to $138,415
Omaha, Nebraska area prices
were up 0.8% 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