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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Job SummaryThis position is responsible for maintaining and enhancing the image of Blue Cross and Blue Shield of Montana through proper channels of influence and public relations with members of the State Legislature, Congress and executive branch of government at the State and Federal level. Responsible for government relations with regulatory agencies such as Office of the Commissioner of Securities and Insurance and the Department of Health and Human Services including coordinating with Legal and various internal Compliance areas. Responsible for guiding legislative and health policy strategy with direction and oversight of external contracted lobbyists. Direct promotions through special events designed to showcase the Plan as a business and corporate citizen.JOB REQUIREMENTS:
* Bachelor's Degree
* 10 or more years of experience working with Congress, government relations, congressional lobbying, and management at the federal level.
* Knowledge of legislative process as well as understanding of health policy issues and federal health programs as they relate to the private insurance market.
* Knowledge of the insurance industry and pertinent legislation and issues impacting the industry.
* Demonstrated political confidence and ingenuity and skill in negotiating and influencing others.
* Strong planning, organizational, and analytical skills.
* Ability to achieve results under demanding time constraints and changing priorities.
* Demonstrated ability to articulate corporate position and the business implications for numerous and wide-ranging audiences.
* Strong interpersonal skills and oral/written communications skills.
* Research and analytical skills to synthesize complex legislation and regulations
* Verbal and written communications skills
PREFERRED JOB REQUIREMENTS:
* Direct government or political experience
* Health care industry experience
* Post-graduate work in Public Policy
Please note, this role is hybrid/flex requiring in-office visibility three days per week in our Helena, MT office.
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HCSC Employment Statement:HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.
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