Managed Care Supervisor jobs in New Mexico

Managed Care Supervisor supervises and coordinates activities of personnel in the managed care operations department of a healthcare facility. Oversees staff that process referrals, authorizations, billing, utilization review, and capitation for hospital services. Being a Managed Care Supervisor experienced in utilization review techniques and protocols. Requires a bachelor's degree. Additionally, Managed Care Supervisor typically reports to a manager or head of a unit/department. May require Registered Nurse (RN). Makes day-to-day decisions within or for a group/small department. Has some authority for personnel actions. The Managed Care Supervisor supervises a group of primarily para-professional level staffs. May also be a level above a supervisor within high volume administrative/ production environments. To be a Managed Care Supervisor typically requires 3-5 years experience in the related area as an individual contributor. Thorough knowledge of functional area and department processes. (Copyright 2024 Salary.com)

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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 medication utilization, formulary management, and ensuring cost-effective pharmacy services. The ideal candidate will bring a deep understanding of managed care principles, a proactive approach to problem-solving, and a commitment to optimizing pharmacy outcomes within a managed care environment.

    Preferred Qualifications:
    PharmD degree from an accredited pharmacy program
    Previous experience in Pharmacy Benefit Management (PBM) or Managed Care
    Knowledge of formulary development and management
    State pharmacy license in good standing
    Strong analytical and data interpretation skills
    Excellent communication and negotiation abilities
    Familiarity with healthcare regulations and compliance standards
    Collaboration experience with healthcare providers, payers, and pharmaceutical manufacturers
    Proficiency in utilizing pharmacy management software and tools
    Active participation in relevant professional organizations
    Dedication to staying informed about industry trends and innovations

    Responsibilities:
    Collaborate with healthcare stakeholders to implement and optimize pharmacy benefit programs
    Conduct formulary reviews and assessments to ensure cost-effective and evidence-based medication choices
    Monitor and analyze pharmacy utilization trends, identifying opportunities for cost savings and improved patient outcomes
    Provide expertise in drug utilization management and prior authorization processes
    Stay informed about industry regulations, guidelines, and emerging trends in managed care pharmacy
    If you are a passionate and experienced pharmacist with a background in PBM or Managed Care, we invite you to join our dynamic team dedicated to advancing healthcare through innovative and cost-effective pharmacy solutions. Apply now to contribute to the future of managed care pharmacy.
  • 9 Days Ago

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Director of Managed Care & Contracting
  • HME Specialists LLC
  • Albuquerque, NM FULL_TIME
  • About the job HME Specialists is a fast growing primary player in NM providing Durable Medical Equipment, Home Infusion and LTC/Hospice services The Director of Managed Care & Contracting will oversee...
  • 2 Months Ago

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Director of Managed Care & Contracting
  • HME Specialists LLC
  • Albuquerque, NM FULL_TIME
  • About the job HME Specialists is a fast growing primary player in NM providing Durable Medical Equipment, Home Infusion and LTC/Hospice services The Director of Managed Care & Contracting will oversee...
  • 2 Months Ago

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Managed Care Provider Relations Specialist
  • UNM Medical Group
  • Albuquerque, NM FULL_TIME
  • UNM Medical Group, Inc is hiring a Provider Relations Specialist to join our Office of Managed Care and Clinical Contract Services Team. This busy and passionate team is looking for a highly motivated...
  • 2 Months Ago

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Managed Care Provider Relations Specialist
  • UNM Medical Group
  • Albuquerque, NM FULL_TIME
  • UNM Medical Group, Inc is hiring a Provider Relations Specialist to join our Office of Managed Care and Clinical Contract Services Team. This busy and passionate team is looking for a highly motivated...
  • 2 Months Ago

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RN Supervisor
  • RED ROCKS CARE CENTER
  • Gamerco, NM PART_TIME
  • Now Hiring a Weekend Supervisor! With Updated Rates.RedRocks Center is looking for full-time, part-time, prn / casual nurses for the day shift and night shift to join our geriatric/long-term care team...
  • 2 Days Ago

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Care Supervisor
  • ComForCare
  • Lansdale, PA
  • Benefits: Bonus based on performance Competitive salary Flexible schedule Paid time off Wellness resources Full job desc...
  • 6/2/2024 12:00:00 AM

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Animal Care Supervisor
  • Petco Animal Supplies, Inc.
  • Crystal Lake, IL
  • Create a healthier, brighter future for pets, pet parents and people! If you want to make a real difference, create an e...
  • 6/2/2024 12:00:00 AM

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Animal Care Supervisor
  • Petco Animal Supplies, Inc.
  • Santa Clarita, CA
  • Create a healthier, brighter future for pets, pet parents and people! If you want to make a real difference, create an e...
  • 6/2/2024 12:00:00 AM

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Residential Care Supervisor
  • THE CENTERS FOR HABILITATION
  • Mesa, AZ
  • Job Description Job Description Direct Care Supervisor II (Tempe) 3197 WHO WE ARE: TCH has been serving the needs of ind...
  • 6/1/2024 12:00:00 AM

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Residential Care Supervisor
  • THE CENTERS FOR HABILITATION
  • Gilbert, AZ
  • Job Description Job Description Direct Care Supervisor II (Tempe) 3196 WHO WE ARE: TCH has been serving the needs of ind...
  • 6/1/2024 12:00:00 AM

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Floor Care Supervisor
  • Threes Co Carpet & Uphostery I
  • Pikesville, MD
  • Job Description Job Description Starting salary 21.77 per hour Part time position averaging 30 hours per week Some night...
  • 6/1/2024 12:00:00 AM

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Child Care Supervisor
  • Stratton Mountain
  • Rutland, VT
  • Please note, this position is located at Stratton Mountain Resort inStratton Mountain, VT Year Round At Stratton, we are...
  • 5/31/2024 12:00:00 AM

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Child Care Supervisor
  • Stratton Mountain
  • Lebanon, NH
  • Please note, this position is located at Stratton Mountain Resort inStratton Mountain, VT Year Round At Stratton, we are...
  • 5/31/2024 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 Supervisor jobs
$70,513 to $97,308

Managed Care Supervisor in Columbia, SC
The Supervisor Business Services of Government Billing and Collections will be responsible for the overall AR management of all government inventory.
January 02, 2020
Managed Care Supervisor in Colorado Springs, CO
In Service to Our Community is achieved through streamlined, coordinated and comprehensive high-quality, compassionate care close to home.
February 15, 2020
Managed Care Supervisor in Portland, ME
·        Minimum one year resolving claims issues with Payer Relations representatives to handle managed care contract implications.
February 19, 2020