Managed Care Provider Relations Manager jobs in Louisiana

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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Managed Care Associate / Baton Rouge
  • Ascent Health, Inc.
  • Baton Rouge, LA FULL_TIME
  • Ascent Health, Inc.
    Location: Baton Rouge, LA

    Managed Care Associate

    The Managed Care Associate plays a vital role in tracking daily clinical operations within our organization. This position involves working closely with supervisors, facilitators, and leadership at Ascent to ensure efficient coordination and tracking of all clinical submissions to Magellan, our Managed Care Organization (MCO). The Director of Managed Care supervises this position.

    Tracking Responsibilities
    • Maintain ongoing tracking of families referred to Wraparound.
    • Update the company census daily, including Magellan submissions, new referrals, assessments, and discharges.
    • Maintain electronic records of all submissions to Magellan, such as plans of care, discharges, new referrals, and assessments.
    • Handle FTP (File Transfer Protocol) drops of non-Medicaid paperwork to Magellan.
    • Manage initial document submissions to FTP for Magellan.
    • Keep track of due dates and short authorizations, communicating deadlines to staff on a weekly basis.
    • Complete and submit all discharge paperwork to Magellan.
    Other Responsibilities
    • Assign new referrals received from Magellan.
    • Enter new referrals into the Electronic Health Records (EHR) system.
    • Make initial contact with new referrals within 48 hours and update EHR.
    • Assign transfer cases within the company and in EHR.
    • Coordinate with Wraparound Supervisors.
    Required
    • Bachelor's degree in a human service-related field preferred.
    • Minimum of two years of relevant experience.
    • Proficiency in data entry using computers and computer systems. Experience working with an EHRs preferred.
    • Strong proficiency in MS Word, Excel, and Outlook.
    Key Competencies
    • Ability to maintain confidentiality in all aspects of client (i.e., HIPPA, FERPA, PL 46:56) staff and agency information.
    • Exceptional organizational and detail-oriented skills with the ability to meet deadlines.
    • Excellent interpersonal, verbal, and written communication skills.
    • Highly dependable and willing to work within a team.
    • Ability to communicate positively and professionally in a diverse and active environment.
    Benefits

    At Ascent, we are not only passionate about elevating the lives of the youth and families we serve but also the lives of our employees. Ascent offers a full range of benefits to regular, full-time employees. These benefits include:
    • Company insurance coverage that includes medical, dental, vision, and more, including a $6,000.00 employer contribution towards medical, dental, and vision premiums.
    • Paid holidays and paid time off.
    • Cell phone allowance and mileage reimbursement.
    • $500.00 loyalty increase each year of employment.
    About Ascent

    Ascent Baton Rouge offers Wraparound Services to the following Parishes: W. Feliciana, E. Feliciana, Pointe Coupee, E. Baton Rouge, W. Baton Rouge, Iberville, and Ascension. The wraparound process is an intensive, individualized care management process for youths with serious or complex needs. Research shows that the wraparound process does more for children than basic child welfare services alone. According to numerous independent studies, most youths in welfare programs that interacted with Ascent move on to less restrictive environments and are significantly less likely to engage in illegal or delinquent behavior. We believe everyone has been empowered with unique gifts and responsibilities and strive to elevate people from where they are today to where they can be tomorrow.

    We hope you will consider joining us in our mission to serve communities and inspire change!
  • 4 Days Ago

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Provider Relations Specialist - Verity
  • Verity HealthNet
  • Baton Rouge, LA FULL_TIME
  • Roles & Responsibilities The Provider Relations Specialist is an integral member of the Verity Network and operations development teams. The person selected for this role is responsible to deliver ind...
  • 5 Days Ago

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Provider Relations Representative
  • American Health Plans LLC
  • Baton Rouge, LA FULL_TIME
  • American Health Plans manages institutional special needs plans (I-SNPs) in nursing homes in several states by sharing plan ownership with the facilities. Our roots in managed care run deep. We owned ...
  • 1 Month Ago

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Medical Provider - Urgent Care
  • The Urgent Care
  • Orleans, LA FULL_TIME
  • General Position Description: To provide patients with outstanding patient care by applying best practices and quality service to aid in the health and well-being of our patients, while also standing ...
  • 4 Days Ago

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Provider - Urgent Care
  • The Urgent Care
  • La Place, LA FULL_TIME
  • General Position Description: To provide patients with outstanding patient care by applying best practices and quality service to aid in the health and well-being of our patients, while also standing ...
  • 21 Days Ago

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Provider - Urgent Care
  • The Urgent Care
  • Orleans, LA FULL_TIME
  • General Position Description: To provide patients with outstanding patient care by applying best practices and quality service to aid in the health and well-being of our patients, while also standing ...
  • 21 Days Ago

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Relationship Manager
  • Trove Family Office
  • Boston, MA
  • Company Overview Trove is an administrative financial services company that understands the complex needs of highnet-wor...
  • 4/19/2024 12:00:00 AM

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Relationship Manager
  • Alfred University
  • Alfred, NY
  • The University of Advancement is looking to fill two positions as the Relationship Manager. The Relationship Manager is ...
  • 4/19/2024 12:00:00 AM

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Relationship Manager
  • TCS Equipment Finance
  • Draper, UT
  • TCS Relationship Manager – Job Description TCS Equipment Finance is a leading private equipment financing company in the...
  • 4/18/2024 12:00:00 AM

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Relationship Manager
  • Brookstone Capital Management
  • Wheaton, IL
  • About Us: Brookstone Capital Management is a dynamic and forward-thinking national Financial Services firm with ~$9B in ...
  • 4/17/2024 12:00:00 AM

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Relationship Manager - Relationship Manager, AS Relationship Management
  • The Charles Schwab Corporation
  • San Francisco, CA
  • Advisor Services, the leading provider of custodial, operational and trading support for independent fee-based investmen...
  • 4/17/2024 12:00:00 AM

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Relationship Manager
  • Insight Global
  • Oakdale, MN
  • Title: Relationship Manager Location: Oakdale, MN Salary: ~$51k w/Quarterly Bonuses Targeting $12k per year Requirements...
  • 4/17/2024 12:00:00 AM

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Relationship Manager
  • WaFd Bank
  • Boise, ID
  • Min: USD $85,000.00/Yr. Max: USD $130,000.00/Yr. Job Summary: A Relationship Manager is responsible for developing a bus...
  • 4/17/2024 12:00:00 AM

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Relationship Manager
  • Rockland Trust
  • Hyannis, MA
  • Rockland Trust is currently seeking a dynamic and client-focused Relationship Manager to join our Hyannis/Osterville tea...
  • 4/16/2024 12:00:00 AM

Louisiana is bordered to the west by Texas; to the north by Arkansas; to the east by Mississippi; and to the south by the Gulf of Mexico. The state may properly be divided into two parts, the uplands of the north, and the alluvial along the coast. The alluvial region includes low swamp lands, coastal marshlands and beaches, and barrier islands that cover about 20,000 square miles (52,000 km2). This area lies principally along the Gulf of Mexico and the Mississippi River, which traverses the state from north to south for a distance of about 600 mi (970 km)) and empties into the Gulf of Mexico; ...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Provider Relations Manager jobs
$95,954 to $138,415

Managed Care Provider Relations Manager in Trenton, NJ
Rizk says McKesson has created a collegial relationship by reaching out to providers.
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Managed Care Provider Relations Manager in Gary, IN
Aetna (57% favorable/37% unfavorable) has turned around providers by changing leadership and addressing provider concerns.
February 24, 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