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)
ScionHealth is recruiting for a Director of Managed Care Analytics to join our team!
Job Summary
The Director of Managed Care Analytics is responsible for supporting the Vice President Managed Care as well as the Managed Care Contracting team in contract modeling, strategic planning, budgeting, financial analysis, and evaluating potential acquisitions. This role supports managed care, hospital operations, and physician operations across the ScionHealth enterprise by providing analysis managed care financial metrics, including but not limited to volume trends, contract yield, financial performance analysis, benchmarking, and trend analyses to support strategic pricing.
Primary Responsibilities
Education
Bachelor's degree in Business Administration, Accounting, Finance, or commensurate experience in Health Care or Managed Care industry.
Licensure/Certification
Project Management certification preferred, but not required.
Experience
8-10 years of progressive experience in financial and data analysis in the Healthcare industry.