Managed Care Provider Relations Manager jobs in Nebraska

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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Chronic Care Coordinator (Part-Time 5/10 Hours)
  • Nebraska Provider Alliance LLC
  • Holdrege, NE PART_TIME
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    Title: Chronic Care Coordinator (LPN or CMA)

    Department: Chronic Care Management

    Reports To: Care Coordination Manager

    Supervises: N/A

    Status: Part-Time: 5-10 hours per week, additional hours as primary coverage for the team is needed.

     

    Hello, We Are ruralMED!

    Join our mission of supporting rural healthcare through collaboration focused on strategically tailored services, effective leadership, and industry-specific expertise.

    When you join our Care Coordination team as a Chronic Care Coordinator (Licensed Practical Nurse (LPN) or Certified Medical Assistant (CMA)) you are not just responsible for providing outreach communication to patients and families enrolled in our Chronic Care Management Program, you get to play a vital role in supporting rural healthcare, the communities they serve, and making a difference for the betterment of patient’s quality of life.

    Having multiple chronic health conditions can be debilitating for patients since they are hard to navigate and manage. Maybe you have or had a grandparent, mother, or father who has or is currently struggling with managing their chronic illnesses. Or, as a nurse, you have seen this happen to countless patients. This position is an amazing opportunity to support countless patients, help them stay on track, and empower them to manage their chronic conditions and illnesses.

    As a Chronic Care Coordinator, you will play the coordination and communication role between patients with chronic health conditions and their physician(s) and care teams. You will review and update care plans under the direction of the patient’s physician and support your patients on their journey of managing their health and finding a higher quality of life.

     

    How This Role Makes an Impact:

    • Utilizing your knowledge, compassion, and communication skills, you will experience the rewarding satisfaction of helping patients achieve a better quality of life at home.
    • You will work alongside a team of dedicated and passionate individuals who are driven to support each other and provide the highest quality of care.
    • Applying your adaptability, attention to detail, and prioritization skills, you will coordinate care and support patients, their families, and providers in managing their chronic health illnesses through an easy-to-use text platform and over the phone.
    • You will become one of your patients’ key resources for supporting their journey to managing their chronic health illnesses.

     

    What It’s Like Working at ruralMED:

    • Our elite and highly skilled team are driven by delivering top-notch results and supporting each other to reach a new level of excellence while making a positive impact on our clients and rural healthcare.
    • Discover flexibility and autonomy with a company that understands the true value and benefits of work-life balance.
    • Personal and professional growth opportunities are encouraged, and employee engagement is not just a measurement, it is a valuable tool for achieving brilliance.
    • Our core values are not only motivational, but they are also the standard for how we conduct and take pride in our work.
      • It Begins With You: Own it.
      • Pave the Way. Never Settle.
      • Be Thoughtful. Be Transparent. Be Extraordinary.
      • Work Fearlessly. Celebrate the Wins.
      • Capitalize Our Strengths. Achieve Excellence.

     

    How to Succeed in this Role:

    • Excellent and Effective Communication (Written and Spoken), Attention to Detail, Prioritization, and Critical Thinking Skills.
    • Ability to take direction and work independently.
    • Licensed as a Practical Nurse (LPN) or Certified as a Medical Assistant (CMA) – Preferred
    • Ability to follow processes and medical protocols and be able to flex and adjust to the highest priorities.
    • Proficiency with technology including Microsoft Office products, or a natural ability to be trained and pick up on how to utilize “new-to-you” software platforms.
    • Character Traits: Self-motivated, Empathetic, Adaptable, Attentive, Responsive, and a passion for providing patient care.  

     

    Flexible Schedule!:

    Hours for this position are flexible when not providing primary coverage for the team!

     

    Location:

    This position is remote and available to candidates who reside within the state of Nebraska or Kansas.

     

    Position Summary:

    The Chronic Care Management Licensed Practical Nurse or Medical Assistant provides outreach communication with patients and families enrolled in our Chronic Care Management Program by assessing chronic conditions, reconciling medications as well as reviewing and updating care plans under the direction of the physician and coordination with the care teams to help the patient meet their goals. Compliance with rules and regulations of all applicable federal, state and local laws as well as ruralMED policies is a condition of employment.

     

    Qualifications:

    Education and/or Experience:

    - High school diploma or equivalent.
    - Licensed Practical Nurse: Degree or diploma from an accredited school of Practical Nursing.
    - Medical Assistant: Must have successfully completed and graduated from a medical assistant program.

     

    Licenses/Certifications Required:

    • Licensed Practical Nurse: Currently Licensed as a Practical Nurse (LPN) in the state of Nebraska

    • Current BLS / CPR certification

     

    General Requirements/Job Duties:

     

    Incumbent must have the skills, ability, and judgment to perform the following essential job duties and responsibilities with or without reasonable accommodation:

    1. Assesses and/or obtains data regarding the patient’s physical, psychological, social, and spiritual dimensions based on the patient’s age and development.
    2. Reports and documents all observed symptoms, reactions, and changes in the patients’ condition to the Physician, APC and/or Registered Nurse as appropriate.
    3. Enrolls patients in the CCM program.
    4. Creates nursing interventions as needed/required to help patients meet goals outlined in the provider’s care plan. (LPN)
    5. Communicates to the patient and supports nursing interventions as needed/required to help patients meet goals outlined in the provider’s care plan.
    6. Communicates with staff nurses, providers, and program managers to address any and all issues with patients enrolled in the CCM program.
    7. Reviews assigned patients on a monthly basis.
    8. Documentation in the CCM Platform and EMR to ensure compliance with the CCM program.
    9. Assists in the development, implementation, revision, and evaluation of a formal plan of care for patients enrolled in our program.
    10. Creates and maintains a comfortable and safe virtual environment for patients, caregivers, clients, and other employees.
    11. Organizes and prioritizes daily assignments to provide optimal patient care and increase productivity.
    12. Conforms and complies with ruralMED Management Resources Codes of Conduct and with procedures, regulations, and rules in maintaining medical records.
    13. Maintains patient and employee confidentiality at all times.
    14. Demonstrates competency annually in assigned areas of work.
    15. Other duties as assigned/needed.

     

     

    Security/Access:

    N/A

     

    Equipment Used:

    Computer, Printer, eFax, Phone, Softphone, and other equipment needed.

     

    Patient Age Groups Served:

    All ages.

  • 18 Days Ago

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PBM / Managed Care Pharmacist
  • Pharmacy Careers
  • Omaha, NE 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...
  • 8 Days Ago

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Provider Relations Associate
  • TEKsystems
  • Lincoln, NE FULL_TIME
  • Provider Relations SpecialistM-F 8-5pmFully remote role, must be able to train on site in Lincoln, NE before working remotely and live in Nebraska.Description:• Maintains contract knowledge to ensure ...
  • 1 Month Ago

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Provider Relations Supervisor
  • TEKsystems
  • Lincoln, NE FULL_TIME
  • We are seeking a detail-oriented Administrative Specialist to join our team. As an Administrative Specialist, you will be responsible for maintaining contract knowledge to ensure accurate and complian...
  • 1 Month Ago

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Afternoon Child Care Provider
  • Salem Little Saints Christian Child Care Center
  • Fremont, NE FULL_TIME
  • Apply on-line Now Position Description Applicant must be 18 years or older and previous experience preferred.Skills needed for this position:Working well with othersMultitaskingExcellent communication...
  • 3 Days Ago

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Preschool Child Care Provider
  • Salem Little Saints Christian Child Care Center
  • Fremont, NE FULL_TIME
  • Apply on-line Now Position Description Applicant would be responsible for the care of children who are 3 years old. Applicant Must be at least 18 years of age. Previous experience required.Skills need...
  • 5 Days Ago

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Relationship Manager
  • BHI
  • Miami, FL
  • Job Summary This positions primary responsibility is new business development and existing / new account management. Ori...
  • 3/28/2024 12:00:00 AM

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Relationship Manager
  • Claire Myers Consulting
  • Wichita Falls, TX
  • Our client is a dynamic, boutique wealth management firm with a mission to educate the community on all things financial...
  • 3/28/2024 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...
  • 3/28/2024 12:00:00 AM

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Relationship Manager
  • OPENLANE
  • Fredericksburg, VA
  • Who We Are: At AFC (Automotive Finance Corporation) we fuel the entrepreneurial dream in our community. For more than 30...
  • 3/26/2024 12:00:00 AM

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Relationship Manager
  • WaFd Bank
  • Medford, OR
  • Min: USD $85,000.00/Yr. Max: USD $130,000.00/Yr. Job Summary: A Relationship Manager is responsible for developing a bus...
  • 3/26/2024 12:00:00 AM

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Relationship Manager
  • BSF
  • Walnut Creek, CA
  • POSITION OVERVIEW: The Relationship Manager is responsible for developing and managing client relationships with local b...
  • 3/26/2024 12:00:00 AM

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Relationship Manager
  • East West Bancorp, Inc.
  • New York, NY
  • Introduction Since 1973, East West Bank has served as a pathway to success. With over 120 locations across the U.S. and ...
  • 3/26/2024 12:00:00 AM

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Relationship Manager
  • Citizens Business Bank
  • Bakersfield, CA
  • Exact compensation may vary based on skills, experience and/or education, and location. This position is also eligible f...
  • 3/26/2024 12:00:00 AM

The state is bordered by South Dakota to the north; Iowa to the east and Missouri to the southeast, across the Missouri River; Kansas to the south; Colorado to the southwest; and Wyoming to the west. The state has 93 counties and is split between two time zones, with the state's eastern half observing Central Time and the western half observing Mountain Time. Three rivers cross the state from west to east. The Platte River, formed by the confluence of the North Platte and the South Platte, runs through the state's central portion, the Niobrara River flows through the northern part, and the Rep...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Provider Relations Manager jobs
$94,436 to $136,231

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