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Become A Manager, Provider Relations

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Working As A Manager, Provider Relations

  • Communicating with Supervisors, Peers, or Subordinates
  • Making Decisions and Solving Problems
  • Establishing and Maintaining Interpersonal Relationships
  • Evaluating Information to Determine Compliance with Standards
  • Developing and Building Teams
  • Deal with People

  • Unpleasant/Angry People

  • Mostly Sitting

  • Make Decisions

  • $94,500

    Average Salary

What Does A Manager, Provider Relations Do At Highmark Health

* Oversee administration of critical and timely communication to providers through ongoing personal contacts, site visits, regional communication sessions, meetings with professional organizations to communicate initiatives and changes.
* Ensures appropriate and consistent cash flow to professional providers.
* Participate in strategic development and implementation of incentive plan arrangements and innovative payment methodologies as directed by corporate strategy and contracting management.
* Responsible for maintaining an adequate, credentialed network.
* Plan, direct and evaluate provider relations activities related to regulatory compliance.
* Promote efficient communications between providers and the Organization through e
* Commerce.
* Perform administrative and personnel activities
* Other duties as assigned or requested

What Does A Manager, Provider Relations Do At Baystate Health

* Manages day-to-day operations to ensure staffing efficiencies and accuracy for provider charges through creation and implementation of monitoring processes of staff and providers
* Develop and maintain productivity benchmarks
* Identify and resolve provider charge submission and documentation issues through routine reporting processes; collaborate with providers and provider leadership to resolve issues through evaluation of workflow, education and establishing routine reports by provider
* Develops and disseminates coding policies and processes throughout the Baystate Health provider coding network in all regions to ensure consistent, accurate coding for provider services
* Collaborates with senior provider leadership to streamline and improve existing charge processes, develop new processes and identify opportunities for maximization of accurate revenue capture.
* Works closely with Provider Compliance to ensure maximization of revenue in a compliant environment

What Does A Manager, Provider Relations Do At Ascension Health

* Acquires, plans, and transitions new physician practices.
* Engages in physician contract development and negotiations, financial analysis, operations and practice transition planning.
* Serves as negotiator for contracts with physicians.
* Facilitates contracts and review by appropriate departments.
* Meets with hospital administration and/or physician practice to obtain information/specifications and to assess the economics and other characteristics of the opportunity.
* Reviews overall recruitment process and makes strategic recommendations to obtain best possible outcomes.
* Collaborates with appropriate departments to develop effective physician marketing plans.
* Markets opportunity to potential candidates.
* Manages staff relations including performance management, staff satisfaction and conflict management.
* Performs and oversees scheduling, recruitment and payroll

What Does A Manager, Provider Relations Do At Aseracare

* Grow business through new and existing referral sources.
* Initiation of leads through relationships with qualified sources and contact with patients and families
* Identify referral opportunities through market intelligence and territory management data
* Match company services with patient needs
* Develop and implement special events and presentations to assist in maximizing fair market share
* Represent and promote full line of company services by assigned locations
* Facilitate patient transition to company services
* Meet and exceed company established targets
* Effectively utilize company resources to grow business
* Collaborate with appropriate center employees and/or Direct Connect to determine new sources for leads
* Utilize company database to input all sales activities on a daily/weekly basis.
* Create weekly sales report reflecting the week's activities and referrals
* Create and report to appropriate management the 30/60/90 day business development plan
* CODE OF CONDUCT
* Must adhere to the Company's Code of Conduct and Business Ethics policy including documentation and reporting responsibilities.
* Position Requirements

What Does A Manager, Provider Relations Do At Aids Healthcare Foundation

* Responsibilities include assisting with interviewing, hiring, training, planning, assigning, directing work, performance appraisals, rewarding and disciplining employees and addressing complaints.
* Req No: 2017
*

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How To Become A Manager, Provider Relations

Most medical and health services managers have at least a bachelor’s degree before entering the field. However, master’s degrees are common and sometimes preferred by employers. Educational requirements vary by facility.

Education

Medical and health services managers typically need at least a bachelor’s degree to enter the occupation. However, master’s degrees are common and sometimes preferred by employers. Graduate programs often last between 2 and 3 years and may include up to 1 year of supervised administrative experience in a hospital or healthcare consulting setting.

Prospective medical and health services managers typically have a degree in health administration, health management, nursing, public health administration, or business administration. Degrees that focus on both management and healthcare combine business-related courses with courses in medical terminology, hospital organization, and health information systems. For example, a degree in health administration or health information management often includes courses in health services management, accounting and budgeting, human resources administration, strategic planning, law and ethics, health economics, and health information systems.

Work Experience in a Related Occupation

Many employers require prospective medical and health services managers to have some work experience in either an administrative or a clinical role in a hospital or other healthcare facility. For example, nursing home administrators usually have years of experience working as a registered nurse.

Others may begin their careers as medical records and health information technicians, administrative assistants, or financial clerks within a healthcare office.

Important Qualities

Analytical skills. Medical and health services managers must understand and follow current regulations and adapt to new laws.

Communication skills. These managers must effectively communicate policies and procedures with other health professionals and ensure their staff’s compliance with new laws and regulations.

Detail oriented. Medical and health services managers must pay attention to detail. They might be required to organize and maintain scheduling and billing information for very large facilities, such as hospitals.

Interpersonal skills. Medical and health services managers discuss staffing problems and patient information with other professionals, such as physicians and health insurance representatives.

Leadership skills. These managers are often responsible for finding creative solutions to staffing or other administrative problems. They must hire, train, motivate, and lead staff.

Technical skills. Medical and health services managers must stay up to date with advances in healthcare technology and data analytics. For example, they may need to use coding and classification software and electronic health record (EHR) systems as their facility adopts these technologies.

Licenses, Certifications, and Registrations

All states require licensure for nursing home administrators; requirements vary by state. In most states, these administrators must have a bachelor’s degree, complete a state-approved training program, and pass a national licensing exam. Some states also require applicants to pass a state-specific exam; others may require applicants to have previous work experience in a healthcare facility. Some states also require licensure for administrators in assisted-living facilities. For information on specific state-by-state licensure requirements, visit the National Association of Long Term Care Administrator Boards.

A license is typically not required in other areas of medical and health services management. However, some positions may require applicants to have a registered nurse or social worker license.

Although certification is not required, some managers choose to become certified. Certification is available in many areas of practice. For example, the Professional Association of Health Care Office Management offers certification in medical management, the American Health Information Management Association offers health information management certification, and the American College of Health Care Administrators offers the Certified Nursing Home Administrator and Certified Assisted Living Administrator distinctions.

Advancement

Medical and health services managers advance by moving into higher paying positions with more responsibility. Some health information managers, for example, can advance to become responsible for the entire hospital’s information systems. Other managers may advance to top executive positions within the organization.

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Top Skills for A Manager, Provider Relations

NetworkProvidersProviderRelationsRepresentativesHospitalsMedicaidHealthPlanMedicareAdvantageHealthCareProvidersIPAProviderEducationCustomerServiceOversightProviderCommunityProviderDataNetworkDevelopmentEDIHMOPrimaryCareAncillaryProvidersNcqaProviderIssues

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Top Manager, Provider Relations Skills

  1. Network Providers
  2. Provider Relations Representatives
  3. Hospitals
You can check out examples of real life uses of top skills on resumes here:
  • Interfaced with network providers and proactively cultivates ongoing relationships on a regular basis to maintain and improve provider satisfaction.
  • Supported Provider Relations representatives in contacting and helping providers with issues.
  • Managed company's relationships with physicians, hospitals, and health care support staff within an assigned territory.
  • Developed and maintained supportive relationship with NJ Medicaid Providers participating in the Division of Child Behavioral Services program.
  • Recruit, negotiate and contract physicians to maintain adequate specialty networks for multiple Health Plans throughout the state of Florida.

Top Manager, Provider Relations Employers

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