Managed Care Provider Relations Manager jobs in Pennsylvania

• Three (3) weeks paid vacation, plus One (1) week paid Winter Break
• Medical, Dental, Vision, Voluntary & Supplemental Life Insurance through CIGNA
• Cafeteria Plan through Benefit Wallet: FSA and Commuter plans

Essential Functions

• Manages and monitors all MOMobile Managed Care activities and ensures quality of services.
• Provides supervision to managed care advocates and student intern(s).
• Responsible for recruitment and hiring of managed care advocates.
• Acts as a community liaison between MCC, clients, and Medicaid managed care organizations (MCOs) and manages referrals from MCO partners.
• Routinely communicates with MCO providers and schedules monthly/bi-monthly check-in meetings.
• Oversees the contract scope of services with MCO partners.
• Prepares and submits all reports and invoices as required by funders.
• Develops and monitors program budgets and spending.
• Communicates and coordinates contract requirements with other MCC program managers.
• Facilitates regular staff meetings and conducts individual supervisory meetings.
• Conducts regular home visit observations.
• Provides direct services to a small caseload when needed.
• Regularly reviews client files and provides feedback to staff.
• Prepares performance evaluations with input from staff.
• Identifies staff training needs and writes yearly training plans.
• May be required to travel the eight-county region

Other Tasks

• Adheres to the MCC’s security guidelines and ensures the appropriate handling of sensitive information.
• Attends relevant staff meetings to promote communication and execution of goals.
• Completes special projects specific to the function of the department or as needed for the department as directed by the supervisor.
• Other duties as assigned within the scope of position expectations.

Knowledge, Skills, and Abilities

• Understanding of MCC’s mission, goals, and objectives and ability to work independently with a high level of energy and contribute as part of a larger team.
• Knowledge of the concepts and practices associated with community health issues, particularly with pregnant women, prenatal care, parenting and other services for mothers, young children, and their families.

• Ability to travel in and around the Greater Philadelphia region to conduct home visits and community outreach.
• Knowledge of and sensitivity to issues facing the community served.

• Experience in client management procedures for determining eligibility, assessing needs, identifying resources, making referrals, following up, and documenting client interactions.
• Demonstrated clinical social work skills.

• Strong interpersonal skills as demonstrated by compassionate, courteous, cordial, cooperative, and professional interaction with diverse groups of co-workers, community partners, clients, and members of the community.
• Ability to operate a computer and use a variety of common software programs including Microsoft Office, spreadsheets, and customized databases.
• Effective and accurate documentation of case notes and client data according to established client management documentation procedures.
• Ability to organize tasks in an efficient manner and follow-up and follow-through with strong attention to detail.
• Proficient with Microsoft Office Suite, ability to operate a computer and use a variety of common software programs a must
• Experience utilizing virtual meeting platforms
• This is a telecommuting position. Staff are required to be onsite at least (1) day a week (you can add your requirement). In addition, staff must establish a safe and supportive workspace at home.

Experience, Education, and Licensure

• Master’s degree in social work or related field strongly preferred; bachelor’s degree required.
• 2 years of supervisory experience preferred
• Valid driver’s license