Managed Care Provider Relations Manager jobs in Nebraska

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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PBM / Managed Care Pharmacist
  • Pharmacy Careers
  • Omaha, NE 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.
  • 22 Days Ago

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Child Care Provider/Teacher
  • Saint Michael's Child Care
  • Hastings, NE PART_TIME
  • We are currently looking for qualified individuals to join our team! Candidates should be caring, patient, dependable, and fun! Year-round part-time positions available, late afternoon/closing shift. ...
  • 4 Days Ago

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Quality Assurance Manager
  • Provider Resources, Inc.
  • Omaha, NE FULL_TIME
  • Position Description: Quality Assurance Manager Under the direction of the Program Manager for the Independent Dispute Resolution Entity (IDRE) or their delegate, the Quality Assurance Training Manage...
  • 20 Days Ago

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Child Care Provider
  • Salem Little Saints Christian Child Care Center
  • Fremont, NE FULL_TIME
  • Applicant would be responsible for helping the head teacher care for children between the ages of 6 weeks - 5 years old. Skills needed for this position: Working well with others Multitasking Excellen...
  • 1 Month Ago

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Afternoon Child Care Provider
  • Salem Little Saints Christian Child Care Center
  • Fremont, NE FULL_TIME
  • Apply on-line Now Position Description Applicant must be 18 years or older and previous experience preferred.Skills needed for this position:Working well with othersMultitaskingExcellent communication...
  • 14 Days Ago

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Preschool Child Care Provider
  • Salem Little Saints Christian Child Care Center
  • Fremont, NE FULL_TIME
  • Apply on-line Now Position Description Applicant would be responsible for the care of children who are 3 years old. Applicant Must be at least 18 years of age. Previous experience required.Skills need...
  • 17 Days Ago

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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
  • Wilson Hand LLC
  • Salt Lake City, UT
  • At Wilson Hand LLC, our strength is in how we efficiently deliver leading-edge tax products and support to our clients, ...
  • 6/10/2024 12:00:00 AM

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Relationship Manager
  • Wind River Payments
  • Madison, WI
  • As a Relationship Manager at Wind River Payments (WRP), you will thrive on building strong, long-term client relationshi...
  • 6/9/2024 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

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Relationship Manager
  • High Flows Capital
  • Company Description We suggest you enter details here. Role Description This is a full-time on-site role for a Relations...
  • 6/8/2024 12:00:00 AM

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Relationship Manager
  • AFC Automotive Finance Corporation
  • Austin, TX
  • Who We Are: At AFC (Automotive Finance Corporation) we fuel the entrepreneurial dream in our community. For more than 35...
  • 6/8/2024 12:00:00 AM

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Relationship Manager
  • ComForCare
  • Monroe, NC
  • At ComForCare Home Care, we value our employees like family. We celebrate success and have fun. Our focus is to help our...
  • 6/8/2024 12:00:00 AM

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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 ...
  • 6/7/2024 12:00:00 AM

The state is bordered by South Dakota to the north; Iowa to the east and Missouri to the southeast, across the Missouri River; Kansas to the south; Colorado to the southwest; and Wyoming to the west. The state has 93 counties and is split between two time zones, with the state's eastern half observing Central Time and the western half observing Mountain Time. Three rivers cross the state from west to east. The Platte River, formed by the confluence of the North Platte and the South Platte, runs through the state's central portion, the Niobrara River flows through the northern part, and the Rep...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Managed Care Provider Relations Manager jobs
$95,474 to $137,724

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