Manager, provider relations vs provider relations representative

The differences between managers, provider relations and provider relations representatives can be seen in a few details. Each job has different responsibilities and duties. While it typically takes 4-6 years to become a manager, provider relations, becoming a provider relations representative takes usually requires 6-12 months. Additionally, a manager, provider relations has an average salary of $59,029, which is higher than the $40,957 average annual salary of a provider relations representative.

The top three skills for a manager, provider relations include medicaid, patients and network development. The most important skills for a provider relations representative are customer service, provider relations, and medicaid.

Manager, provider relations vs provider relations representative overview

	Manager, Provider Relations	Provider Relations Representative
Yearly salary	$59,029	$40,957
Hourly rate	$28.38	$19.69
Growth rate	28%	-4%
Number of jobs	41,992	203,893
Job satisfaction	-	-
Most common degree	Bachelor's Degree, 63%	Bachelor's Degree, 58%
Average age	47	40
Years of experience	6	12

What does a manager, provider relations do?

A manager of provider relations is primarily in charge of developing strategies to optimize a company's client service operations. In businesses, it is their duty to set objectives and guidelines, manage provider relations staff, oversee schedules and budgets, gather and analyze data, study the clients' feedback, and address any issues and concerns, resolving them in a timely and efficient manner to ensure client satisfaction. Furthermore, as a manager, it is vital to lead and encourage teams to reach goals while implementing the company's policies and regulations.

What does a provider relations representative do?

Provider relations specialists are professionals who work for insurance companies as the primary contact for health care providers such as clinics and hospitals. These specialists are required to provide answers about service contracts and billing procedures to health care providers. They must handle the documents of patients to ensure that proper paperwork has been filed for coverage while developing communications with providers about any policy changes. Provider relations specialists must also travel to different health care organizations to provide training to their staff on insurance policies and procedures.

Manager, provider relations vs provider relations representative salary

Managers, provider relations and provider relations representatives have different pay scales, as shown below.

	Manager, Provider Relations	Provider Relations Representative
Average salary	$59,029	$40,957
Salary range	Between $41,000 And $83,000	Between $30,000 And $55,000
Highest paying City	-	Helena, MT
Highest paying state	-	Montana
Best paying company	-	Parkland Hospital
Best paying industry	-	Health Care

Differences between manager, provider relations and provider relations representative education

There are a few differences between a manager, provider relations and a provider relations representative in terms of educational background:

	Manager, Provider Relations	Provider Relations Representative
Most common degree	Bachelor's Degree, 63%	Bachelor's Degree, 58%
Most common major	Business	Business
Most common college	University of Pennsylvania	-

Manager, provider relations vs provider relations representative demographics

Here are the differences between managers, provider relations' and provider relations representatives' demographics:

	Manager, Provider Relations	Provider Relations Representative
Average age	47	40
Gender ratio	Male, 31.7% Female, 68.3%	Male, 24.2% Female, 75.8%
Race ratio	Black or African American, 10.9% Unknown, 4.3% Hispanic or Latino, 15.1% Asian, 7.3% White, 61.8% American Indian and Alaska Native, 0.7%	Black or African American, 12.1% Unknown, 5.3% Hispanic or Latino, 21.8% Asian, 6.5% White, 53.7% American Indian and Alaska Native, 0.7%
LGBT Percentage	12%	7%

Differences between manager, provider relations and provider relations representative duties and responsibilities

Manager, provider relations example responsibilities.

Manage inbound and outbound freight thru strategic relationships with key logistics groups.
Lead the development of the PPO network for Virginia, Maryland and DC.
Manage technical, operational, strategic, and economic analysis of vendor RFP responses for loop access products.
Improve network stability and speed by planning and managing upgrade of 10base-T LAN with coax backbone to 100base-T LAN.
Develop Linux shell scripts to automate the configuration and administration of proprietary wireless network equipment.
Evaluate and lead publishing and content management processes, DNS configurations, security requirements, web application architecture.

Provider relations representative example responsibilities.

Help manage ACO program and review measures with provider offices.
Advise clients on health care and manage care products including POS, PPO and medical management programs.
Provide keen oversight in developing and maintaining quality improvement programs while managing payroll.
Manage software maintenance renewal partner and assist with upselling additional and higher functionality licenses to increase revenue.
Review the provider contracts, paid members claims, base on the CPT code & ICD-9 that are submitted.
Review provider claims for CPT and ICD-9 coding accuracy and generate payment of claims base upon current fee schedule.

Manager, provider relations vs provider relations representative skills

Common manager, provider relations skills

Medicaid, 15%
Patients, 6%
Network Development, 5%
Oversight, 4%
HMO, 4%
Training Programs, 3%

Common provider relations representative skills

Customer Service, 16%
Provider Relations, 9%
Medicaid, 9%
Patients, 6%
Health Plan, 5%
PowerPoint, 4%

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Executive Management Industry
Manager, Provider Relations
Manager, Provider Relations vs Provider Relations Representative

Updated January 8, 2025

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