Managed Care Provider Relations Manager jobs in Columbia, SC

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)

T
Manager of Provider Relations Specialists - ACO Industry
  • ttg Talent Solutions
  • Columbia, SC FULL_TIME
  • Manager of Provider Relations Specialists
    (Manager or Director level based on exp)
    South Carolina (Horry, Lexington, Beaufort, Orangeburg, Richland, Effingham, and Charleston counties)

    Field-based w/ Travel up to 60% within the area
    Local candidates preferred (must live in any or close to the above county)

    **The ideal candidate has a combination of management, and/or leadership in ACO/MSO's , as well as being a Physician’s Performance Specialist ( or similar ) earlier in their career within the ACO/MSO industry**

    Our client:
    Our client is a value-based healthcare company, offering physicians the opportunity to be part of Accountable Care Organizations (ACOs) with savings in the Medicare system. (Saving of $32.2 million in 2022). It also achieved a 100% grade for quality. This is a Value-Based Care Company Outperforms Benchmarks For the Eighth Consecutive Year, Shares Bonus Payments With Participating Physicians

    Summary
    The Director of Physician Performance is responsible for implementing and monitoring key strategic initiatives to enhance physician engagement, with the primary objective of driving a high-performing network. They are responsible for the management and successful leadership of all Physician Performance specialists, helping ensure their effectiveness in serving as a “single point of contact”, increasing physicians’ engagement and participation in all initiatives and overall driving improved financial, revenue, and quality performance across the network.

    Essential Duties and Responsibilities
    • Carries out supervisory responsibilities in accordance with the organization's policies and applicable laws.
    • Responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.
    • Develop and execute a cohesive physician engagement strategy.
    • Responsible for the ‘overall’ (e.g., cost, revenue, quality, retention, and growth)performance of the network, including ensuring year-over-year improvements on key performance indicators.
    • Analyze physician performance metrics and use data and reporting to continuously improve performance and engagement strategies, and tailored engagement plans for each physician.
    • Manage a team of physician performance professionals, providing coaching, mentoring, and professional development opportunities.
    • Monitor team’s productivity against key performing indicators, and other quota requirements to ensure job expectations are being fulfilled and effective.
    • Direct all priority and focus items for the team ensuring that time and effort is spent in areas that will make the most impact.
    • Coordinate and ensure that all specialists have been properly trained and have all the necessary tools to make them effective while engaging with physician partners.
    • Implement, and oversee the maintenance of business processes and workflows that increase effectiveness and efficiency, and overall position team to support continued growth.
    • Develop and maintain direct strong working relationships with key physician partners.
    • Monitor and ensure that all physician partners are met, on a regular cadence, which will be based on various factors, and are being provided with clear and actionable data.
    • Mentor and guide team in helping to independently identify key trends and performance gaps upon review of reporting and assisting with the development of targeted initiatives.
    • Responsible for conducting ride-along visits with a team of specialists on a regular cadence to monitor the effectiveness of visits and relationships.
    • Prepare and present executive reporting to key customers and stakeholders.
    Knowledge, Skills and Abilities
    • Excellent leadership, management, and project management skills
    • Ability to work independently and demonstrate initiative in identifying problems, creating solutions, and developing systems to maximize effectiveness.
    • Ability to communicate effectively and work with cross-functional teams.
    • Ability to embrace, manage diversity and build and maintain successful teams.
    • Effective problem-solving and ability to analyze and use data for decision-making.
    • Effectively interact with people and develop positive relationships while being tactful, respectful, and direct in communication
    • Effectively build teams, achieving results, and driving results through others
    • Proficient in Microsoft Outlook, Excel, and other web-based software
    • Strong customer service focus: ability to effectively interface with and influence internal/external stakeholders.
    • Excellent verbal and written communication skills

    Requirements
    • Bachelor’s degree from an accredited institution or equivalent combination of education and experience
    • 7 years of experience in a healthcare-related position, Specifically, in the MSO/ACO Industry
    • Must have a combo of Management and/or Leadership Experience, as well as experience as a Physician’s Performance Specialist earlier in your career is required.
    • Experience leading and/or managing a team of at least 5 members
    • Travel up to 60% within the South Carolina region (Horry, Lexington, Beaufort, Orangeburg, Richland, Effingham, and Charleston counties or close by)
    • Proficient in MS Office programs (i.e., Word, Excel, Outlook, Access, and PowerPoint). Moderate to advanced Excel skills to include charts, graphs, pivot tables, macros, etc.

    Compensation
    Excellent based Salary $120K- $150K (title and experience will be based on experience), offering some 100% subsidized benefits plans, 18 PTO days, Holidays, car and cell allowance ( under review).

    Apply
    Please submit your resume in a word document . A cover letter would be helpful to describe why you are a good match. If you are a good match, you will be contacted by a ttg Talent Solutions recruiter to schedule a video interview ASAP.

    At ttg, "We believe in making a difference One Person at a Time," ttg OPT.
  • 8 Days Ago

S
Managed Care Coordinator I
  • Spectraforce Technologies
  • Columbia, SC FULL_TIME
  • Job Title: Managed Care Coordinator I Location: Columbia, SC. 29229 (Remote after 1 week onsite training) Duration: 3 months assignment with possible extension. Shift: Mon-Fri, 8:30 am to 5:00 pm. Pay...
  • 1 Month Ago

Y
Provider Relations Coordinator
  • Your Health Organization
  • Lexington, SC FULL_TIME
  • Job Summary: The Provider Relations Coordinator serves as a liaison between the healthcare organization and its network of healthcare providers, including physicians, specialists, hospitals, clinics, ...
  • 12 Days Ago

Y
Provider Relations Coordinator
  • Your Health Organization
  • Columbia, SC FULL_TIME
  • Job Summary: The Provider Relations Coordinator serves as a liaison between the healthcare organization and its network of healthcare providers, including physicians, specialists, hospitals, clinics, ...
  • 12 Days Ago

M
Managed Care Licensing and Credentialing Liaison
  • Medical Services of America
  • Lexington, SC FULL_TIME
  • Our Credentialing Support Specialist will be responsible to complete, submit and track credentialing data while demonstrating high attention to detail and accuracy with emphasis on timeliness. We are ...
  • 18 Days Ago

P
Managed Care Coordinator II (31995382)
  • Professional Management Enterprises
  • Columbia, SC FULL_TIME
  • Seeking anRNwithManaged Care and Utilization Managementexperience to review and evaluate medical or behavioral eligibility regarding benefits and clinical criteria. This position is remote, but requir...
  • 26 Days Ago

Filters

Clear All

  • Filter Jobs by companies
  • More

0 Managed Care Provider Relations Manager jobs found in Columbia, SC area

C
Medical Equipment Outside Sales Representative
  • Confidential
  • Columbia, SC
  • Company Overview: We are a dynamic and rapidly growing organization dedicated to patient care through the provision of h...
  • 4/25/2024 12:00:00 AM

C
Customer Service Advocate I
  • Centene Corporation
  • Columbia, SC
  • You could be the one who changes everything for our 28 million members as a Customer Care professional at Centene. As a ...
  • 4/24/2024 12:00:00 AM

M
TRAVEL NURSE RN - PCU - $1,970 PER WEEK IN COLUMBIA, SC
  • Mindlance Health
  • Columbia, SC
  • 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

O
Relationship Associate
  • OPENLANE, Inc.
  • Leesville, SC
  • Location: Remote opportunity but needs to be local to Leesville, SC. Who We Are: At AFC (Automotive Finance Corporation)...
  • 4/24/2024 12:00:00 AM

M
TRAVEL NURSE RN - MED/SURG - $1,970 PER WEEK IN COLUMBIA, SC
  • Mindlance Health
  • Columbia, SC
  • Most of our positions require at least 2 years of nursing experience, with an active RN license and BLS and/or ACLS (if ...
  • 4/23/2024 12:00:00 AM

T
Logistics Sales Representative
  • Tmc Transportation
  • Columbia, SC
  • Logistics Sales Representative in Columbia, SC at TMC Transportation Become a part of the nations largest employee-owned...
  • 4/23/2024 12:00:00 AM

C
Director of School Partnerships - Special Education - South (REMOTE)
  • Catapult Learning Inc.
  • Columbia, SC
  • Director of School Partnerships - Special Education - South (REMOTE) Location: SC, SC, United StatesDate Posted: Apr 18,...
  • 4/23/2024 12:00:00 AM

S
Customer Service Representative
  • Shimadzu Group
  • Columbia, SC
  • ** Customer Service Representative** **Job Category****:** Operations **Requisition Number****:** CUSTO001790 Showing 1 ...
  • 4/23/2024 12:00:00 AM

One of Columbia's more prominent geographical features is its fall line, the boundary between the upland Piedmont region and the Atlantic Coastal Plain, across which rivers drop as falls or rapids. Columbia grew up at the fall line of the Congaree River, which is formed by the convergence of the Broad River and the Saluda River. The Congaree was the farthest inland point of river navigation. The energy of falling water also powered Columbia's early mills. The city has capitalized on this location which includes three rivers by christening itself "The Columbia Riverbanks Region". Columbia is lo...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Provider Relations Manager jobs
$93,532 to $134,922
Columbia, South Carolina area prices
were up 1.5% 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