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 SummaryUnder supervision, this position is responsible for call intake from network dental providers to respond to questions and resolve concerns regarding incoming provider inquiries such as contract, credentialing status and fee schedules to ensure provider satisfaction and resolution of questions. Handling the identification and correction of Provider data issues. Supporting the Provider Administration functions in order to maintain compliance with established procedures and quality standards.Job Qualifications
* High school diploma or GED.
* 6 months customer service experience OR 6 months experience in office environment
* Knowledge of dental benefits, contracts and all lines of dental business preferred
* Ability to spend up to 90% of the scheduled time on the phone according to business needs and sit for long periods of time with scheduled breaks.
* Experience prioritizing tasks and workflow.
* Experience working well under pressure and meet deadlines.
* Organizational skills.
* Must be dependable and a team player.
* Decision -making skills and demonstrated attention to detail.
* Clear and concise verbal and written communication skills.
* PC proficiency in Word and Excel.
THIS IS A FLEX ROLE WORKING a minimum of 3 DAYS IN THE 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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