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)
Careers With Purpose
Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We're proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint.
Facility: 45th St Business Center
Location: Fargo, ND
Address: 300 45th St S, Fargo, ND 58103, USA
Shift: 8 Hours - Day Shifts
Job Schedule: Full time
Weekly Hours: 40.00
Salary Range: $24.00 - $38.50
Job Summary
The Senior Provider Relations Specialist is responsible for acting as a resource to all Health Plan employees specifically the employees of the Provider Relations Department. Gains extensive knowledge in the assigned subject matter. For the information system application(s) and a basic working knowledge of the enterprise healthcare information system applications. Uses analytical skills and experiences to investigate/resolve and/or escalate support issues. Incorporates techniques to assist and/or lead training sessions. Must have ability to train and provide documentation of the assigned application to users with varying education and learning abilities. Assists in the creating and maintenance of training documentation or on-line training courses. Utilizes project management principles to assist in achieving states outcomes. Creates and analyzes data reports. Keeps departmental leadership and project leaders advises of outstanding issues and support needs. Performs with a high level of customer service skills on all support and training requirements. Promotes and participates in the team approach to support and manage projects.
Qualifications
Minimum of a Bachelor’s degree required, preferable in business, a health care or computer related field.
Benefits
Sanford Health offers an attractive benefits package for qualifying full-time and part-time employees. Depending on eligibility, a variety of benefits include health insurance, dental insurance, vision insurance, life insurance, a 401(k) retirement plan, work/life balance benefits, and a generous time off package to maintain a healthy home-work balance. For more information about Total Rewards, visit https://sanfordcareers.com/benefits .
Sanford is an EEO/AA Employer M/F/Disability/Vet. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-877-673-0854 or send an email to talent@sanfordhealth.org .
Sanford Health has a Drug Free Workplace Policy. An accepted offer will require a drug screen and pre-employment background screening as a condition of employment.
Req Number: R-0188439
Job Function: General Administration
Featured: No