Managed Care Supervisor jobs in Virginia
Managed Care Supervisor supervises and coordinates activities of personnel in the managed care operations department of a healthcare facility. Oversees staff that process referrals, authorizations, billing, utilization review, and capitation for hospital services. Being a Managed Care Supervisor experienced in utilization review techniques and protocols. Requires a bachelor's degree. Additionally, Managed Care Supervisor typically reports to a manager or head of a unit/department. May require Registered Nurse (RN). Makes day-to-day decisions within or for a group/small department. Has some authority for personnel actions. The Managed Care Supervisor supervises a group of primarily para-professional level staffs. May also be a level above a supervisor within high volume administrative/ production environments. To be a Managed Care Supervisor typically requires 3-5 years experience in the related area as an individual contributor. Thorough knowledge of functional area and department processes. (Copyright 2024 Salary.com)
Recently Added Managed Care Supervisor jobs
Credential and Managed Care Coordinator
- Virginia Oncology Associates
-
Norfolk, VA
FULL_TIME
-
Overview:
Virginia Oncology Associates, the largest group of medical professionals in Hampton Roads and Northeast North Carolina devoted exclusively to cancer care and blood disorders, has an exciting opportunity for a Credentialing Managed Care Coordinator for our office in Norfolk.
***Please take this quick survey once you've submitted your resume to complete the application process: Credential and Managed Care PI Survey
Responsibilities:- Credentials and re-credentials providers according to quality standards and company policies and procedures. Notifies providers of licensure expirations and submits licensure applications and renewal forms with payment to State agencies and appropriate departments. Recommends process improvements.
- Maintains current provider licensure files and provides information to hospitals and other healthcare providers as appropriate. Requests and completes hospital credentialing and privileges applications for providers.
- Obtains and maintains provider participation in managed care plans in a timely manner and communicates information to practice sites and business office.
- May implement and maintain the contract management system to include terms of the contract, providers credentialed to the payer and other contracted service providers (labs, hospitals).
- May complete EOB analyses or fee schedule variance reporting on a monthly basis for the top Managed Care payers according to policy and procedure. May produce monthly managed care reports and implement new analysis tools to assist in reporting functions.
- May maintain expected reimbursement by CPT code for the top payer contracts in each market and communicate changes to system librarian.
- May develop and provide maintenance of proformas for all contracts.
- Supports Network Contracting Representative/Manager in general administrative functions.
- Trains junior and practice staff with respect to credentialing contracts, policies and procedures.
- Other duties as requested or assigned.
- High school diploma or equivalent required.
- Technical certification or Associates Degree a plus.
- At least five (5) years of credentialing related work experience required.
- Proficiency with computer systems and Microsoft (Office Outlook, Word, Power Point, and Excel) required.
- CPCS certification is preferred.
- 9 Days Ago
PBM / Managed Care Pharmacist
- Pharmacy Careers
-
Virginia, VA
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
Managed Care Coordinator - Foster Care
- The Elevance Health Companies, Inc.
-
NORFOLK, VA
OTHER
- Anticipated End Date: 2024-06-03 Position Title: Managed Care Coordinator - Foster Care Job Description: The Foster Care Managed Case Manager is responsible for overall management of member's individu...
- Just Posted
Managed Care Coordinator - Foster Care
- Elevance Health
-
Norfolk, VA
FULL_TIME
- Job Family: MED > Care Coord & Care Mgmt (Non-Licensed) Type: Date Posted: Apr 16, 2024 Anticipated End Date: May 20, 2024 Reference: JR113650 Description The Foster Care Managed Case Manager is respo...
- 5 Days Ago
Case Manager (Managed Care Coordinator)
- Elevance Health
-
Virginia, VA
FULL_TIME
- Description Case Manager (Managed Care Coordinator) MUST LIVE WITHIN 50 MILES OF THE ARLINGTON PULSEPOINT A proud member of the Elevance Health family of companies, Carelon Behavioral Health, formerly...
- 24 Days Ago
Production Supervisor - Martinsville, VA
- Signode -Production Supervisor
-
Martinsville, VA
FULL_TIME
- Production Supervisor - Martinsville, VA Apply Now Description/Job Summary About Signode:With over $2B in revenue, 80 manufacturing facilities across 6 continents and over 9,000 employees worldwide, S...
- 3 Days Ago
Managed Care Supervisor jobs at Popular Companies
About Virginia
Virginia (/vərˈdʒɪniə/ (listen)), officially the Commonwealth of Virginia, is a state in the Southeastern and Mid-Atlantic regions of the United States located between the Atlantic Coast and the Appalachian Mountains. Virginia is nicknamed the "Old Dominion" due to its status as the first English colonial possession established in mainland North America and "Mother of Presidents" because eight U.S. presidents were born there, more than any other state. The geography and climate of the Commonwealth are shaped by the Blue Ridge Mountains and the Chesapeake Bay, which provide habitat for much of ...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Supervisor jobs
$76,375 to $105,406
Most Popular Cities in Virginia for Managed Care Supervisor Jobs
What does a Managed Care Supervisor do?
Managed Care Supervisor in Columbia, SC
The Supervisor Business Services of Government Billing and Collections will be responsible for the overall AR management of all government inventory.
January 02, 2020
Managed Care Supervisor in Colorado Springs, CO
In Service to Our Community is achieved through streamlined, coordinated and comprehensive high-quality, compassionate care close to home.
February 15, 2020
Managed Care Supervisor in Portland, ME
· Minimum one year resolving claims issues with Payer Relations representatives to handle managed care contract implications.
February 19, 2020