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)
To support our associates in their journey to become a U.S. citizen, Brookdale offers to advance fees for naturalization (Form N-400) application costs, up to $725, less applicable taxes and withholding, for qualified associates who have been with us for at least a year.
The Regional Case Manager position assists with referral management, coordination of provider approvals, and provides comprehensive clinical and rehabilitation updates with managed care and BPCI/Bundled payment payer groups. Regional Case Managers ensure appropriate level of reimbursement for patient specific care needs and work collaboratively with interdisciplinary team and providers.
This job description represents an overview of the responsibilities for the above referenced position. It is not intended to represent a comprehensive list of responsibilities. An associate should perform all duties as assigned by his/her supervisor.
Minimum Requirements
Certifications, Licenses, and Other Special Requirements
None
Physical Demands and Working Conditions
Brookdale is an equal opportunity employer and a drug-free workplace.