Provider Programs Manager jobs in Indiana

Provider Programs Manager oversees the provider network administration function of an organization. Collects data, analyzes and reports on claims, utilization, costs and changes. Being a Provider Programs Manager reviews existing and future reimbursement policies, regulations and guidelines. Ensure competitiveness of provider network by the deployment of cost effective programs and systems that deliver results that meet cost control and quality goals of the organization. Additionally, Provider Programs Manager requires a bachelor's degree. Typically reports to a manager or head of a unit/department. The Provider Programs 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 Provider Programs 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 II GBD Special Programs (Provider Audit)
  • Elevance Health
  • INDIANAPOLIS, IN FULL_TIME
  • Description

    Location: Indianapolis, IN, Tampa FL, Grand Prairie TX, Nashville TN, Richmond VA

    Hours: M – F Standard Working hours

    Travel: Hybrid (1-2 days onsite per week)


    Position Overview:

    The Manager II of GBD Special Programs is responsible for management and oversight of multi state program operations and will support the overall strategic approach of the LTSS Center of Excellence. The position is responsible for the development, implementation, and coordination of comprehensive provider auditing for effective oversight, monitoring, and quality improvement of LTSS service providers and vendors.

    How You Will Make an Impact:

    • Directs and oversees program operations in support of corporate and health plan management specific to provider auditing functions and fiscal intermediary oversight.

    • Directs and collaborates with functional managers to develop and implement the steps necessary to manage program operations across all LTSS markets.

    • Implements provider auditing and oversight practices in new LTSS markets.

    • Leads policy/process development and ensuring adherence to contractual and federal requirements specific to LTSS providers in collaboration with necessary teams.

    • Participates in cross-functional workgroups created to maintain and develop program.

    • Evaluates program operations to improve efficiency of operations, financial return, customer service, and provider engagement.

    • Develops, communicates, and monitors program schedule, budget, and resources plan.

    • Manages resource utilization to ensure appropriate delivery of care to members and adequate coverage for departmental tasks and job responsibilities.

    • Hires, trains, coaches, counsels, and evaluates performance of direct reports.

    Required Qualifications:

    • Requires a BA/BS and minimum of 6 years’ experience, including prior management experience; or any combination of education and experience, which would provide an equivalent background.

    Preferred Qualifications:

    • Experience in self-directed Healthcare programs

    • Experience in Healthcare provider auditing strongly preferred

    • Project management experience preferred

    • Data analytics experience preferred

    • Change management experience is a plus

    • Experience leading a team strongly preferred


     

    Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

    Who We Are

    Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

    How We Work

    At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

    We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

    Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.

    The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

    Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.comfor assistance.

  • Just Posted

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Account Manager, Defense Programs
  • EV.Careers
  • Indianapolis, IN FULL_TIME
  • JOIN THE TEAM THAT’S POWERING PROGRESSBuilding cities. Driving commerce. Saving lives. For over 100 years, Allison Transmission has powered the vehicles and technology that move our world forward.What...
  • 5 Days Ago

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Program Manager, Conservation Programs
  • Rare
  • Brazil, IN FULL_TIME
  • Position Overview About Rare Rare inspires change so people and nature thrive. For over 45 years, across 60 countries, we have inspired and empowered millions of people and communities to shift their ...
  • 18 Days Ago

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Associate Project Manager, Transfer Programs
  • BAXTER
  • Bloomington, IN FULL_TIME
  • This is where you save and sustain lives At Baxter, we are deeply connected by our mission. No matter your role at Baxter, your work makes a positive impact on people around the world. You’ll feel a s...
  • 26 Days Ago

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Manager, Provider Network Performance
  • CareSource Management Services LLC
  • Indiana, IN FULL_TIME
  • Job Summary: The Manager, Provider Network Performance provides leadership and direction to staff to ensure the goals of the department are successfully achieved. Essential Functions: Ensure accurate ...
  • 3 Days Ago

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Manager, Provider Network Development
  • Zelis Healthcare, LLC
  • Indianapolis, IN FULL_TIME
  • Position OverviewResponsible for the overall strategy and development of Zelis contracted network providers (current and prospective) in an effort to increase the savings achieved for Zelis clients fo...
  • Just Posted

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L&D Operations Project Manager
  • US Tech Solutions
  • Austin, TX
  • Duration: 8 months contract, Full-Time Job Type: W-2 Job Description: The Solutions Learning & Enablement team is respon...
  • 6/10/2024 12:00:00 AM

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Executive Director (AL, IL, MC)
  • Provider Management LLC
  • Mill Creek, WA
  • Profile insights Find out how your skills align with the job description Skills Do you have experience in Memory care ? ...
  • 6/10/2024 12:00:00 AM

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Service Provider Manager (SPM) (Referral Management Clerk) - Eglin AFB, FL
  • Reef Systems
  • Eglin Afb, FL
  • Service Provider Manager (SPM) (Referral Management Clerk) - Eglin AFB, FL Background/Experience : Shall read, understan...
  • 6/10/2024 12:00:00 AM

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Programs Manager
  • Franklin
  • Torrington, CT
  • Franklin Products, Inc. is a leading manufacturer of commercial aircraft interior components. We are a global company, o...
  • 6/10/2024 12:00:00 AM

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Program Manager
  • Bayside Solutions
  • Program Manager W2 Contract Salary Range: $83,200 - $104,000 per year Location: Sunnyvale, CA - Hybrid Role Job Summary:...
  • 6/9/2024 12:00:00 AM

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Program Manager
  • Bayside Solutions
  • Sunnyvale, CA
  • Program Manager W2 Contract Salary Range: $83,200 - $104,000 per year Location: Sunnyvale, CA - Hybrid Role Job Summary:...
  • 6/9/2024 12:00:00 AM

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Program Manager
  • Rootshell Inc
  • Santa Clara, CA
  • Hello All, Greetings from Rootshell Inc. Rootshell Enterprise Technologies Inc. is a recognized provider of professional...
  • 6/8/2024 12:00:00 AM

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Program Manager at Global Device Company in Sunnyvale, CA
  • OSI Engineering
  • Sunnyvale, CA
  • This team is seeking a Program Manager who will play a meaningful role within the Project Management Office (PMO) in sup...
  • 6/8/2024 12:00:00 AM

Indiana /ˌɪndiˈænə/ (listen) is a U.S. state located in the Midwestern and Great Lakes regions of North America. Indiana is the 38th largest by area and the 17th most populous of the 50 United States. Its capital and largest city is Indianapolis. Indiana was admitted to the United States as the 19th U.S. state on December 11, 1816. Indiana borders Lake Michigan to the northwest, Michigan to the north, Ohio to the east, Kentucky to the south and southeast, and Illinois to the west. Before becoming a territory, various indigenous peoples and Native Americans inhabited Indiana for thousands of ye...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Provider Programs Manager jobs
$103,755 to $134,023

Provider Programs Manager in Lawrence, MA
Approved aged care service providers must use this portal to manage information about their services, manage referrals, update client records, generate reports and ask an assessor to review a client’s support plan.
February 18, 2020
Provider Programs Manager in Helena, MT
Approved aged care service providers must use the My Aged Care service provider portal.
February 24, 2020
Provider Programs Manager in Fairbanks, AK
In addition, we have intervention, prevention, and other specialty programs that provide community based services in the natural environment and other appropriate settings.
December 27, 2019