Managed Care Provider Relations Manager jobs in South Carolina

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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Manager of Provider Relations Specialists - ACO Industry
  • ttg Talent Solutions
  • Columbia, SC FULL_TIME
  • Manager of Provider Relations Specialists
    (Manager or Director level based on exp)
    South Carolina (Horry, Lexington, Beaufort, Orangeburg, Richland, Effingham, and Charleston counties)

    Field-based w/ Travel up to 60% within the area
    Local candidates preferred (must live in any or close to the above county)

    **The ideal candidate has a combination of management, and/or leadership in ACO/MSO's , as well as being a Physician’s Performance Specialist ( or similar ) earlier in their career within the ACO/MSO industry**

    Our client:
    Our client is a value-based healthcare company, offering physicians the opportunity to be part of Accountable Care Organizations (ACOs) with savings in the Medicare system. (Saving of $32.2 million in 2022). It also achieved a 100% grade for quality. This is a Value-Based Care Company Outperforms Benchmarks For the Eighth Consecutive Year, Shares Bonus Payments With Participating Physicians

    Summary
    The Director of Physician Performance is responsible for implementing and monitoring key strategic initiatives to enhance physician engagement, with the primary objective of driving a high-performing network. They are responsible for the management and successful leadership of all Physician Performance specialists, helping ensure their effectiveness in serving as a “single point of contact”, increasing physicians’ engagement and participation in all initiatives and overall driving improved financial, revenue, and quality performance across the network.

    Essential Duties and Responsibilities
    • Carries out supervisory responsibilities in accordance with the organization's policies and applicable laws.
    • Responsibilities include interviewing, hiring, and training employees; planning, assigning, and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.
    • Develop and execute a cohesive physician engagement strategy.
    • Responsible for the ‘overall’ (e.g., cost, revenue, quality, retention, and growth)performance of the network, including ensuring year-over-year improvements on key performance indicators.
    • Analyze physician performance metrics and use data and reporting to continuously improve performance and engagement strategies, and tailored engagement plans for each physician.
    • Manage a team of physician performance professionals, providing coaching, mentoring, and professional development opportunities.
    • Monitor team’s productivity against key performing indicators, and other quota requirements to ensure job expectations are being fulfilled and effective.
    • Direct all priority and focus items for the team ensuring that time and effort is spent in areas that will make the most impact.
    • Coordinate and ensure that all specialists have been properly trained and have all the necessary tools to make them effective while engaging with physician partners.
    • Implement, and oversee the maintenance of business processes and workflows that increase effectiveness and efficiency, and overall position team to support continued growth.
    • Develop and maintain direct strong working relationships with key physician partners.
    • Monitor and ensure that all physician partners are met, on a regular cadence, which will be based on various factors, and are being provided with clear and actionable data.
    • Mentor and guide team in helping to independently identify key trends and performance gaps upon review of reporting and assisting with the development of targeted initiatives.
    • Responsible for conducting ride-along visits with a team of specialists on a regular cadence to monitor the effectiveness of visits and relationships.
    • Prepare and present executive reporting to key customers and stakeholders.
    Knowledge, Skills and Abilities
    • Excellent leadership, management, and project management skills
    • Ability to work independently and demonstrate initiative in identifying problems, creating solutions, and developing systems to maximize effectiveness.
    • Ability to communicate effectively and work with cross-functional teams.
    • Ability to embrace, manage diversity and build and maintain successful teams.
    • Effective problem-solving and ability to analyze and use data for decision-making.
    • Effectively interact with people and develop positive relationships while being tactful, respectful, and direct in communication
    • Effectively build teams, achieving results, and driving results through others
    • Proficient in Microsoft Outlook, Excel, and other web-based software
    • Strong customer service focus: ability to effectively interface with and influence internal/external stakeholders.
    • Excellent verbal and written communication skills

    Requirements
    • Bachelor’s degree from an accredited institution or equivalent combination of education and experience
    • 7 years of experience in a healthcare-related position, Specifically, in the MSO/ACO Industry
    • Must have a combo of Management and/or Leadership Experience, as well as experience as a Physician’s Performance Specialist earlier in your career is required.
    • Experience leading and/or managing a team of at least 5 members
    • Travel up to 60% within the South Carolina region (Horry, Lexington, Beaufort, Orangeburg, Richland, Effingham, and Charleston counties or close by)
    • Proficient in MS Office programs (i.e., Word, Excel, Outlook, Access, and PowerPoint). Moderate to advanced Excel skills to include charts, graphs, pivot tables, macros, etc.

    Compensation
    Excellent based Salary $120K- $150K (title and experience will be based on experience), offering some 100% subsidized benefits plans, 18 PTO days, Holidays, car and cell allowance ( under review).

    Apply
    Please submit your resume in a word document . A cover letter would be helpful to describe why you are a good match. If you are a good match, you will be contacted by a ttg Talent Solutions recruiter to schedule a video interview ASAP.

    At ttg, "We believe in making a difference One Person at a Time," ttg OPT.
  • 1 Day Ago

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Manager of Provider Relations Sep - ACO Industry
  • ttg Talent Solutions
  • Charleston, SC FULL_TIME
  • Manager of Provider Relations Specialist - ACO Industry(Manager or Director level) South Carolina (Horry, Lexington, Beaufort, Orangeburg, Richland, Effingham, and Charleston counties) Field-based w/ ...
  • 1 Day Ago

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Managed Care Coordinator I
  • Spectraforce Technologies
  • Columbia, SC FULL_TIME
  • Job Title: Managed Care Coordinator I Location: Columbia, SC. 29229 (Remote after 1 week onsite training) Duration: 3 months assignment with possible extension. Shift: Mon-Fri, 8:30 am to 5:00 pm. Pay...
  • 1 Month Ago

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Managed Care Licensing and Credentialing Liaison
  • Medical Services of America
  • Lexington, SC FULL_TIME
  • Our Credentialing Support Specialist will be responsible to complete, submit and track credentialing data while demonstrating high attention to detail and accuracy with emphasis on timeliness. We are ...
  • 11 Days Ago

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Managed Care Coordinator II (31995382)
  • Professional Management Enterprises
  • Columbia, SC FULL_TIME
  • Seeking anRNwithManaged Care and Utilization Managementexperience to review and evaluate medical or behavioral eligibility regarding benefits and clinical criteria. This position is remote, but requir...
  • 19 Days Ago

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Managed Care Coordinator I (31609005)
  • Professional Management Enterprises
  • Columbia, SC FULL_TIME
  • Seeking anRNwithManaged Care and Utilization Managementexperience to review and evaluate medical or behavioral eligibility regarding benefits and clinical criteria. This position is remote, but requir...
  • 19 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

South Carolina (/ˌkærəˈlaɪnə/ (listen)) is a state in the Southeastern United States and the easternmost of the Deep South. It is bordered to the north by North Carolina, to the southeast by the Atlantic Ocean, and to the southwest by Georgia across the Savannah River. South Carolina became the eighth state to ratify the U.S. Constitution on May 23, 1788. South Carolina became the first state to vote in favor of secession from the Union on December 20, 1860. After the American Civil War, it was readmitted into the United States on June 25, 1868. South Carolina is the 40th most extensive and 23...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Provider Relations Manager jobs
$95,248 to $137,396

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