Managed Care Provider Relations Manager jobs in New Mexico

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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Provider Relations Rep
  • Health Care Service Corp.
  • Albuquerque, NM OTHER
  • At HCSC, we consider our employees the cornerstone of our business and the foundation to our success. We enable employees to craft their career with curated development plans that set their learning path to a rewarding and fulfilling career. Come join us and be part of a purpose driven company who is invested in your future! Job Summary This position is responsible for enhancing relationships with facility and physician providers; and acting as liaison with providers through education, training, claims assistance and ongoing provider service. Required Job Qualifications: *Bachelor Degree and 1 year managed care experience in products or contracts OR 5 years’ experience in managed care environment with 1 year experience in products or contracts. *1 year experience in a position that demonstrates leadership abilities and sound decision-making. *Knowledge of contracts, applications and products; claims processing systems. *Knowledge and experience in provider reimbursement methods. *Meet deadlines and work well under pressure and take initiative to work independently. *Verbal and written communication skills; organizational and planning skills. *PC proficiency to include Microsoft Office. *Ability and willingness to travel, including overnight stays. Preferred Job Qualifications: *1 year experience in provider relations. *1 year experience in claims. *This is a hybrid role requiring 3 days in the office and 2 days remote weekly. We encourage people of all backgrounds and experiences to apply. Even if you don’t think you are a perfect fit, apply anyway - you might have qualifications we haven’t even thought of yet. #LI-Hybrid #LI-EL1 #INJLF Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process! 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. Join our talent community and receive the latest HCSC news, content, and be first in line for new job opportunities. Join our Talent Community. For more than 80 years, HCSC has been dedicated to expanding access to high-quality, cost-effective health care and equipping our members with information and tools to make the best health care decisions for themselves and their families. As an industry leader, HCSC also has been helping to make the health care system work better for all Americans. To remain a leader, we offer compelling careers that encourage resourcefulness, strategic thought and empower you to make a difference in the lives of our members and their communities. Today, with the industry at an important crossroad, HCSC is reimagining health care and looking for original thinkers who aren’t afraid to make innovative contributions. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Learn more about HCSC, our commitment to our members and the opportunity you’ll have to improve health care delivery in an open, collaborative environment. HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants. If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can call us at 1-866-977-7378 to request reasonable accommodations. Please note that only requests for accommodations in the application process will be returned. All applications, including resumes, must be submitted through HCSC's Career website on-line application process. If you have general questions regarding the status of an existing application, navigate to "candidate home" to view your job submissions. Legal and Privacy Health Care Service Corporation is an Equal Opportunity Employment / Affirmative Action employer Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of New Mexico, Blue Cross and Blue Shield of Oklahoma, and Blue Cross and Blue Shield of Texas, Divisions of Health Care Service Corporation, a Mutual Legal Reserve Company, and Independent Licensee of the Blue Cross and Blue Shield Association © Copyright 2022 Health Care Service Corporation. All Rights Reserved.
  • 1 Month Ago

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Credential and Managed Care Coordinator
  • US Oncology Network-wide Career Opportunities
  • Santa Fe, NM FULL_TIME
  • OverviewSCOPE:Under direct supervision, maintains and coordinates actions for provider credentialing, licensure, and hospital privileges activities. Provides administrative support to state/practice m...
  • Just Posted

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PBM / Managed Care Pharmacist
  • Pharmacy Careers
  • Albuquerque, NM 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...
  • 3 Days Ago

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Credential and Managed Care Coordinator
  • Nexus Health
  • Santa Fe, NM FULL_TIME
  • Overview:SCOPE: Under direct supervision, maintains and coordinates actions for provider credentialing, licensure, and hospital privileges activities. Provides administrative support to state/practice...
  • 7 Days Ago

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Market Director, Provider Relations & Outreach
  • Lovelace Health System, Inc.
  • Albuquerque, NM FULL_TIME
  • Overview Ardent Health Services is a leading provider of healthcare in communities across the country. Through its subsidiaries, Ardent owns and operates nearly 200 sites of care and 30 hospitals acro...
  • 17 Days Ago

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Personal Care Provider
  • Providence Support Services, Inc.
  • Albuquerque, NM FULL_TIME
  • $15.15 Hourly rate for Direct Care duties: 1)Thurs-Sunday Schedule Thurs/Fri 9:30am-7pm Sat 9 am-8pm, Sunday 9am-7pm 2)Sun- Wednesday Schedule Sun/Monday 9:00am-8:00pm, Tues/Wed 9:30am-7:30pm *Hiring ...
  • 3 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

New Mexico (Spanish: Nuevo México Spanish pronunciation: [ˈnweβo ˈmexiko] (listen), Navajo: Yootó Hahoodzo pronounced [jòːtxó xɑ̀xʷòːtsò]) is a state in the Southwestern region of the United States of America; its capital and cultural center is Santa Fe, which was founded in 1610 as capital of Nuevo México (itself established as a province of New Spain in 1598), while its largest city is Albuquerque with its accompanying metropolitan area. It is one of the Mountain States and shares the Four Corners region with Utah, Colorado, and Arizona; its other neighboring states are Oklahoma to the north...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Provider Relations Manager jobs
$92,836 to $133,922

Managed Care Provider Relations Manager in Trenton, NJ
Rizk says McKesson has created a collegial relationship by reaching out to providers.
January 03, 2020
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