Managed Care Provider Relations Manager jobs in Athens, GA

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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Medicaid Managed Care Manager
  • CBIZ, Inc.
  • GA, GA FULL_TIME
  • Myers and Stauffer LC is a certified public accounting and health care reimbursement consulting firm, specializing in audit, accounting, data management and consulting services to government-sponsored health care programs (primarily state Medicaid agencies, and the federal Center for Medicare & Medicaid Services). We have 45 years of experience assisting our government clients with complex health care reimbursement and provider compliance issues, operate 20 offices and have over 900 associates nationwide.

    At Myers and Stauffer, you will have a career that is rewarding while also supporting our state and federal government healthcare clients that focus on those in need. We are committed to providing our employees with professional growth and development opportunities, a diverse, dynamic, challenging work environment, and a strong and visionary leadership team. 

    What We Offer: 

    • Health, Dental, and Vision insurance along with other competitive employee benefits
    • Vacation time, sick time, paid holidays, and two floating holidays
    • Paid Parental Leave and available support resources
    • 401K with company matching for eligible employees
    • Tuition reimbursement, referral bonuses, paid volunteer community service time, mentor program, and a variety of other employee programs and perks
    • A combination of technical and leadership development training at each career milestone
    • Up to six counseling sessions per year for eligible employees through our Employee Assistance Program

    The Medicaid Managed Care Manager will support project requirements that relate to client management, research, policy development and analysis, Medicaid managed care oversight and compliance, and other ad hoc projects required by state clients. The Manager will coordinate and collaborate with an interdisciplinary team to assess regulatory, policy, and strategic opportunities for Medicaid managed care programs to advance quality, improve health outcomes, and improve cost effectiveness. This position reports to a Senior Manager. Senior Healthcare Consultants and Healthcare Consultants may report to this position.

    Essential Functions:

    • Provide leadership on consulting engagements, effectively supervising staff to provide quality deliverables within the defined deadlines
    • Provide effective client management and interact with multiple levels of client leadership, management, and staff in the delivery of consulting services
    • Develop client-specific subject matter expertise to support client engagements, including client organizational structure, contacts, key contracted vendors, relevant contract language, understanding of regulatory timelines/deadlines for filing contracts and waivers/reporting as applicable, etc.
    • Draft reports and other deliverables as assigned
    • Present  research, analyses, and findings to clients, Managed Care Organizations (MCOs) and other stakeholders
    • Assist staff in completing project deliverables and manage flow of deliverables through required processes
    • Responsible for coordinating and reviewing work performed by staff to ensure quality, accuracy, and completeness
    • Support the development and review process for MCO contract modifications/amendments as needed
    • Conduct detailed reviews of MCO materials to ensure quality and compliance
    • Understand Medicaid policy, program operations, and reimbursement methodologies
    • Stay informed of healthcare trends and state and federal regulations to highlight relevant implications for clients
    • Provide high level technical knowledge and training to staff
    • Additional responsibilities as assigned

    Requirements:

    • Bachelor's degree in a related field preferred or equivalent experience
    • At least 6 years’ of related experience required
    • Minimum 3 years’ of supervisory experience required
    • Experience managing related projects for State Medicaid Agencies and/or supporting the U.S. Department of Health and Human Services programs (Centers for Medicare and Medicaid Services, etc.) strongly preferred. 
    • Experience in gathering requirements, developing work plans, and developing project performance metrics preferred 
    • Must be able to be onsite in the West Virgina Bureau for Medical Services (BMS) main office in Charleston, West Virginia on a quarterly basis for two-three days each visit, as designated by the client
    • Ability to prioritize conflicting demands
    • Must be able to work independently on projects and within a remote team environment 
    • Execute assigned projects within established deadlines
    • Maintain effective relationships with business stakeholders and team members
    • Proficient with Microsoft Project or other related project management tools
    • Strong analytical and problem solving skills
    • Strong verbal and written communication skills
    • Self-motivated and assertive
    • Must be able to travel on occasion based on business and client needs

    The Team: 
    Myers and Stauffer takes pride in the welcoming and collaborative culture we have throughout our offices. For this position, the employee will report to one of our Senior Managers or Directors on the Consulting engagement team.

    Work Style: 
    Our general business hours are Monday through Friday 8am-5pm, but can vary based on business needs. Dependent on performance, our in-office associates are eligible for a hybrid work schedule after their initial 90-day training period. As a company, we are always willing to discuss potential flexibility that an employee may need to better suit their work-life wellbeing. 

    Typical Interview Process:

    • Phone Screen with a Recruiter
    • In person or remote interview with the hiring manager & team
    • Hiring decision and job offer

     

    #LI-HW1

    #LI-Hybrid

  • 1 Day Ago

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Data Entry/Call Care
  • SocialWRX Public & Social Relations
  • Atlanta, GA FULL_TIME
  • Company DescriptionWe value our relationship with our clients and strive to get to know our customers inside and out in order to positively impact our client’s business. SocialWrx succeeds in our abil...
  • 1 Month Ago

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Director of Managed Care
  • SENTA Partners
  • Atlanta, GA FULL_TIME
  • Overview: We are seeking a proactive and experienced Director of Managed Care to lead our managed care initiatives for our ENT and Allergy private practices. The ideal candidate will have a deep under...
  • 3 Days Ago

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Coordinator, Managed Care
  • Independent Physicians Resource Inc.
  • Atlanta, GA FULL_TIME
  • About ApolloMD ApolloMD is a privately held, physician and APC operated multispecialty practice partnering with top hospitals, teaching facilities and health systems across the country. With more than...
  • 29 Days Ago

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PBM / Managed Care Pharmacist
  • Pharmacy Careers
  • Atlanta, GA 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 medicatio...
  • 1 Month Ago

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Interim Finance Director, Managed Care
  • Warbird Consulting Partners
  • Atlanta, GA FULL_TIME
  • Warbird Consulting Partners actively seeks experienced candidates for an Interim Director of Finance role for a client in the Southwest. Our ideal candidate will have strong managed care experience an...
  • 17 Days Ago

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0 Managed Care Provider Relations Manager jobs found in Athens, GA area

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Travel Interventional Radiology Technologist - $2,322 per week
  • Hiring Now!
  • Athens, GA
  • Springboard Healthcare is seeking a travel Interventional Radiology Technologist for a travel job in Athens, Georgia. Jo...
  • 4/27/2024 12:00:00 AM

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Administrative Assistant Reception
  • EntryPoint Doors and Windows of Atlanta
  • Buford, GA
  • Job Description Job Description Position Summary: This role encompasses various administrative and inside sales support ...
  • 4/26/2024 12:00:00 AM

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Sales Executive
  • City Lifestyle
  • Hoschton, GA
  • Join the City Lifestyle Team as a Sales Executive City Lifestyle, formerly known as Lifestyle Publications, has been a p...
  • 4/26/2024 12:00:00 AM

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Sales Executive
  • City Lifestyle
  • Dacula, GA
  • Join the City Lifestyle Team as a Sales Executive City Lifestyle, formerly known as Lifestyle Publications, has been a p...
  • 4/25/2024 12:00:00 AM

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TRAVEL NURSE RN - PCU - $1,770 PER WEEK IN LAWRENCEVILLE, GA
  • Mindlance Health
  • Lawrenceville, GA
  • 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 - GASTROENTEROLOGY - $1,882 PER WEEK IN LAWRENCEVILLE, GA
  • Mindlance Health
  • Lawrenceville, GA
  • 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 - CVICU - $2,602 PER WEEK IN LAWRENCEVILLE, GA
  • Mindlance Health
  • Lawrenceville, GA
  • 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 - TELEMETRY - $2,058 PER WEEK IN SNELLVILLE, GA
  • Mindlance Health
  • Snellville, GA
  • 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

Athens, officially Athens–Clarke County, is a consolidated city–county and college town in the U.S. state of Georgia. Athens lies about 70 mi (113 km) northeast of downtown Atlanta, a Global City and the cultural and economic center of the Atlanta metropolitan area, being in the top ten of the largest metropolitan areas in the nation. It is a component of the larger Atlanta–Athens–Clarke County–Sandy Springs Combined Statistical Area, a trading area. The University of Georgia, the state's flagship public university and a R1 research institution, is in the city and contributed to its initial gr...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Provider Relations Manager jobs
$98,073 to $141,471
Athens, Georgia area prices
were up 1.4% from a year ago

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