Managed Care Provider Relations Manager jobs in Ohio

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 - Provider Relations (Data)
  • EyeMed Vision Care
  • Mason, OH FULL_TIME
  • Requisition ID: 843714
    Position:Full-Time
    Total Rewards: Benefits/Incentive Information

    There’s more to EyeMed than meets the eye. EyeMed is the fastest growing managed vision benefits company in the country with consistent double-digit membership growth! Through our commitment to innovation, we’re reimagining the way employers and their employees think about vision care. We want them to see life to the fullest and experience more of what’s best, not more of the same. And if what’s best hasn’t been done yet, it’s our exceptional and passionate employees driving this change. But, our passion for vision isn’t just about vision insurance benefits. Our employees are proud to support and participate in life-altering global and local missions through our partnership with OneSight, a leading not-for-profit organization with a 100% focus on eradicating the world’s vision crisis.

    Your family says a lot about who you are. EyeMed is a key member of the Luxottica family of companies, global leaders in the design, manufacture and distribution of fashion, luxury and sports eyewear. In North America, Luxottica is the home to global brands Ray-Ban, Oakley and many top fashion house brands. Our leading retail brands include LensCrafters, Sunglass Hut, Pearle Vision, and Target Optical.

    If you’re passionate about driving innovation and change and interested in a career in the optical and insurance industry, EyeMed wants to start the conversation and help provide you a growth-focused opportunity with America’s fastest growing vision benefits company.
    GENERAL FUNCTION
    The Provider Data Manager is responsible for managing a team of production employees, contractors and vendor(s) that perform provider data setup configuration and maintenance within EyeMed core systems. The role involves quality advocacy, resource planning/management and resolution of issues that impact the quality, timeliness and productivity of provider data setup activities. In this capacity, the Provider Data Manager will work with resources within the Team and with other EyeMed Departments and organizations. The Provider Data Manager is also responsible for analyzing performance trends and seeking continuous improvement and automation to increase efficiency and effectiveness of provider data management.

    MAJOR DUTIES AND RESPONSIBILITIES
    • Organize and direct work activities for a team of production resources, with an emphasis on quality, timeliness and productivity.
    • Monitor functional performance against agreed upon business objectives and performance standards and proactively develop remediation plan when required.
    • Drive Key Perfomance Indicators (KPIs) through monitoring, coaching, and reporting of staff productivity.
    • Deliver reports to EyeMed leadership outlining performance relative to targets on a recurring basis, highlighting areas of risk and actions required to mitigate.
    • Maximize performance of individual resources through on-going mentoring, coaching and employee development programs.
    • Ensure provider data standards, policies and desk level procedures are documented and current, ensuring appropriate controls & key compliance requirements are met.
    • Analyze team performance to ensure data integrity, compliance with department standards, identify process improvements, and communicate process changes to team and cross-functional partners.
    • Manage and seek improvement opportunities related to the provider data setup configuration and maintenance
    • Drive high-level team motivation in accordance with company policies, procedures, and standards

    BASIC QUALIFICATIONS
    • Bachelor's Degree in a related field or equivalent work experience
    • 4 years of experience in operations management, staff leadership, and administrative oversight of business processes
    • Proven track record with managing a team of employees in an office production setting
    • Previous experience in the healthcare industry / operations related position
    • Critical thinking skills and the ability to interpret data results to form action plans
    • Excellent communication skills, both written and oral to manage setting direction for a department

    PREFERRED QUALIFICATIONS
    • Managed care experience
    • Experience representing the business in standard software development lifecycle phases (e.g., requirements, design, build, test, deploy)
    • Experience developing executive level presentations
    Employee pay is determined by multiple factors, including geography, experience, qualifications, skills and local minimum wage requirements. In addition, you may also be offered a competitive bonus and/or commission plan, which complements a first-class total rewards package. Benefits may include health care, retirement savings, paid time off/vacation, and various employee discounts.

    Upon request and consistent with applicable laws, EssilorLuxottica will provide reasonable accommodations to individuals with disabilities who need assistance in the application and hiring process. To request a reasonable accommodation, please call the Luxottica Ethics Compliance Hotline at 1-888-887-3348 (be sure to provide your name and contact information so that we may follow up in a timely manner) or email HRCompliance@luxotticaretail.com.

    We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, gender, national origin, social origin, social condition, being perceived as a victim of domestic violence, sexual aggression or stalking, religion, age, disability, sexual orientation, gender identity or expression, citizenship, ancestry, veteran or military status, marital status, pregnancy (including unlawful discrimination on the basis of a legally protected pregnancy or maternity leave), genetic information or any other characteristics protected by law. Native Americans in the US receive preference in accordance with Tribal Law.
  • 17 Days Ago

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Hospice Provider Relations
  • Crossroads Hospice & Palliative Care
  • Mentor, OH FULL_TIME
  • Provider Relations is a results-driven professional who supports the interdisciplinary hospice team by building relationships with doctors, facilities, and other healthcare organizations to obtain ref...
  • 1 Month Ago

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Contracting Manager - Managed Care
  • Summa Health
  • Akron, OH FULL_TIME
  • SummaCare is a Summa Health entity that offers health insurance in northern Ohio. As a regional, provider-owned health plan, SummaCare is based in Akron, Ohio, and provides Medicare Advantage, individ...
  • 1 Month Ago

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Manager, Provider Relations
  • CareSource
  • Columbus, OH FULL_TIME
  • Job Summary:The Manager, Provider Relations is responsible for overseeing and encouraging the collaboration with key Health Partners in the development of specific strategies for enhanced operational ...
  • 5 Days Ago

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Manager - Provider Relations (Data)
  • EssilorLuxottica
  • Mason, OH FULL_TIME
  • Requisition ID: 843714 Position:Full-Time Total Rewards: Benefits/Incentive Information There’s more to EyeMed than meets the eye. EyeMed is the fastest growing managed vision benefits company in the ...
  • 17 Days Ago

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Administrative Officer (Office Manager)
  • National Labor Relations Board
  • Cleveland, OH FULL_TIME
  • This position is located in a Field Office of the National Labor Relations Board. Incumbent serves as the Administrative Officer (Office Manager) to the Regional Director, managing the office administ...
  • 2 Days Ago

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Relationship Manager
  • Palmetto
  • Company Description Recognized by Forbes as one of the fastest-growing private companies in the United States, Palmetto ...
  • 6/12/2024 12:00:00 AM

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Relationship Manager
  • Valley Bank
  • Jacksonville, FL
  • Why you should consider applying to this opportunity: You're excited to build relationships with Commercial & Industrial...
  • 6/12/2024 12:00:00 AM

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Relationship Manager
  • Team Select Home Care
  • Evansville, IN
  • Overview: You can apply by texting TSC to 97211 Now offering DailyPay! Ask us about it! Are you looking for an exciting ...
  • 6/12/2024 12:00:00 AM

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Relationship Manager
  • The Alliance Corporate Office
  • Durham, NC
  • Job Description Job Description We are looking for an outgoing relationship manager to foster strong relationships with ...
  • 6/12/2024 12:00:00 AM

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Relationship Manager
  • Ascensus
  • Greensboro, NC
  • Newport, an Ascensus company, helps employers offer their associates a more secure financial future through retirement p...
  • 6/11/2024 12:00:00 AM

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Relationship Manager
  • GROVER GAMING
  • Elyria, OH
  • Job Description Job Description Job Title: Relationship Manager Department: Ohio Sales Reports To: Sales Manager Status:...
  • 6/11/2024 12:00:00 AM

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Relationship Manager
  • Allium Financial Advisors, LLC
  • Lake Oswego, OR
  • Summary This position is responsible for partnering with Financial Advisors to help manage client relationships by perfo...
  • 6/10/2024 12:00:00 AM

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Relationship Manager
  • Flourish
  • New York, NY
  • Flourish was founded in 2017 with the goal of helping financial advisors to better secure the financial futures of their...
  • 6/9/2024 12:00:00 AM

Ohio /oʊˈhaɪoʊ/ (listen) is a Midwestern state in the Great Lakes region of the United States. Of the fifty states, it is the 34th largest by area, the seventh most populous, and the tenth most densely populated. The state's capital and largest city is Columbus. The state takes its name from the Ohio River, whose name in turn originated from the Seneca word ohiːyo', meaning "good river", "great river" or "large creek". Partitioned from the Northwest Territory, Ohio was the 17th state admitted to the Union on March 1, 1803, and the first under the Northwest Ordinance. Ohio is historically know...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Provider Relations Manager jobs
$99,122 to $142,987

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