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Provider Manager Jobs in Illinois (NOW HIRING)

Coordinate and manage provider enrollment, revalidation, roster management, and demographic maintenance for both delegated and non-delegated agreements behavioral health professionals (LPCs, LMFTs ...

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Provider Manager information

How do I become a provider manager?

To become a provider manager, candidates typically need a bachelor's degree in healthcare administration, business, or a related field, along with relevant experience in healthcare or provider relations. Strong communication, organizational skills, and knowledge of healthcare policies are essential, and some roles may require certification such as Certified Provider Relations Professional (CPRP). Gaining experience in healthcare operations or provider networks can also improve prospects for advancement into this role.

What are some common challenges provider managers face when coordinating between healthcare providers and insurance companies?

Provider Managers often navigate complex relationships between healthcare providers and insurance companies, which can involve resolving contract disputes, ensuring compliance with regulatory standards, and streamlining credentialing processes. They frequently manage competing priorities, such as maintaining strong provider networks while meeting organizational cost and quality goals. Effective communication, negotiation skills, and up-to-date knowledge of industry regulations are crucial for overcoming these challenges and maintaining productive partnerships.

What are the key skills and qualifications needed to thrive as a provider manager, and why are they important?

To thrive as a Provider Manager, you need expertise in healthcare administration, provider relations, and a solid understanding of regulatory compliance, typically supported by a bachelor’s degree in healthcare management or a related field. Familiarity with provider network management systems, credentialing software, and data analytics tools is highly valued. Strong interpersonal skills, negotiation abilities, and effective communication are essential for building relationships with providers and leading teams. These skills and qualities are crucial for ensuring high-quality provider networks, regulatory adherence, and efficient healthcare delivery.

What is a provider manager?

A Provider Manager is a professional responsible for overseeing relationships with healthcare providers, such as physicians, clinics, or hospitals, within an organization like a health insurance company or healthcare network. Their duties often include recruiting new providers, negotiating contracts, ensuring quality standards are met, and serving as a liaison between providers and the organization. Provider Managers play a key role in maintaining a strong provider network, resolving issues, and supporting operational efficiency to ensure members receive high-quality care.

What are the most commonly searched types of Provider jobs in Illinois?

The most popular types of Provider jobs in Illinois are:

What cities in Illinois are hiring for Provider Manager jobs?

Cities in Illinois with the most Provider Manager job openings:

Strategy& Health Services - Payor/Provider, Strategy Consulting Manager

Pwc

Chicago, IL • On-site

Full-time

Medical, Dental, Vision, Retirement, PTO

Re-posted 3 days ago


PwC rating

8.3

Company rating: 8.3 out of 10

Based on 76 frontline employees who took The Breakroom Quiz

26th of 72 rated business consultants


Job description

Industry/Sector

Health Services

Specialism

Corporate and Business Strategy

Management Level

Manager

Job Description & Summary

At PwC, our people in strategy consulting focus on providing strategic guidance and insights to organisations. They analyse market trends, assess business performance, and develop recommendations to help clients achieve their goals. These individuals work closely with clients to identify opportunities for growth, optimise operations, and enhance overall business performance.
As a corporate and business strategy consultant at PwC, you will analyse client needs, provide consulting services across different strategic areas, and offer guidance and support to help clients develop and implement effective strategies that align with their business objectives and drive growth.
Enhancing your leadership style, you motivate, develop and inspire others to deliver quality. You are responsible for coaching, leveraging team member's unique strengths, and managing performance to deliver on client expectations. With your growing knowledge of how business works, you play an important role in identifying opportunities that contribute to the success of our Firm. You are expected to lead with integrity and authenticity, articulating our purpose and values in a meaningful way. You embrace technology and innovation to enhance your delivery and encourage others to do the same.
Examples of the skills, knowledge, and experiences you need to lead and deliver value at this level include but are not limited to:
Analyse and identify the linkages and interactions between the component parts of an entire system.
Take ownership of projects, ensuring their successful planning, budgeting, execution, and completion.
Partner with team leadership to ensure collective ownership of quality, timelines, and deliverables.
Develop skills outside your comfort zone, and encourage others to do the same.
Effectively mentor others.
Use the review of work as an opportunity to deepen the expertise of team members.
Address conflicts or issues, engaging in difficult conversations with clients, team members and other stakeholders, escalating where appropriate.
Uphold and reinforce professional and technical standards (e.g. refer to specific PwC tax and audit guidance), the Firm's code of conduct, and independence requirements.
Minimum Degree Required:
Bachelor Degree
Minimum years experience required
5 years(s) experience
Preferred Qualifications:
Degree Preferred:
Master of Business Administration
Preferred Knowledge/Skills:
Demonstrates extensive knowledge of and/or success in professional services or corporate roles, helping companies define and evaluate corporate and business unit strategies and investment portfolios, reflecting market, competitive and other external drivers.
Demonstrates extensive leadership, strategic and creative thinking, problem solving, individual initiative, and the following abilities:
Building productive and collaborative relationships with team members and proactively providing and seeking guidance, clarification and feedback;
Managing a team to a successful project conclusion through problem solving global, enterprise-wide strategy issues;
Building, maintaining, and utilizing networks of client relationships;
Communicating cogently in an organized and knowledgeable manner in written and verbal formats; and,
Conducting and managing market research and quantitative and qualitative analyses, including the timely synthesis of complex data into meaningful insights and the ability to readily grasp analytical frameworks and employ them effectively to either qualitative or quantitative evidence.
Demonstrates extensive-level abilities as a team leader, emphasizing the following areas:
Possessing working experience in Payor operations (domain areas such as Medical Management, Population Health Management, Utilization Management, Provider Network Management, Value-Based Contracting, Provider Relations, Quality Improvement, Informatics, ACO operations, etc.) to help payors and providers manage their medical costs, quality, and experience;
Possessing working experience in Clinical Analytics, Medical Economics, and/or Population Health Analytics or working in collaboration with related functions;
Possessing working experience with Population Health Management technologies and approaches (e.g., high-risk user stratification tools, cost/quality/utilization trend analysis, provider performance tools);
Possessing working knowledge and experience in software development, implementation, and optimization to accurately translate clinical and business requirements into engineering design documents and instructions;
Possessing experience in project management and product development life cycle management specifically in healthcare product design and development to support care management and delivery workflows;
Possessing understanding of global trends for health organizations utilizing pragmatic approaches to achieve sustainable financial functions, consumer experience, and operating models;
Possessing experience managing and advising healthcare executive leadership or has direct experience from former position; and,
Understanding Medicare Stars performance across different markets and helping to develop strategies and programs to match those needs.

Travel Requirements

Up to 60%

Job Posting End Date

The salary range for this position is: $99,000 - $232,000. Actual compensation within the range will be dependent upon the individual's skills, experience, qualifications and location, and applicable employment laws. All hired individuals are eligible for an annual discretionary bonus. PwC offers a wide range of benefits, including medical, dental, vision, 401k, holiday pay, vacation, personal and family sick leave, and more. To view our benefits at a glance, please visit the following link: https://pwc.to/benefits-at-a-glanceAs PwC is anequal opportunity employer, all qualified applicants will receive consideration for employment at PwC without regard to race; color; religion; national origin; sex (including pregnancy, sexual orientation, and gender identity); age; disability; genetic information (including family medical history); veteran, marital, or citizenship status; or, any other status protected by law.PwC does not intend to hire experienced or entry level job seekers who will need, now or in the future, PwC sponsorship through the H-1B lottery, except as set forth within the following policy: https://pwc.to/H-1B-Lottery-Policy.Learn more about how we work: https://pwc.to/how-we-workFor only those qualified applicants that are impacted by the Los Angeles County Fair Chance Ordinance for Employers, the Los Angeles' Fair Chance Initiative for Hiring Ordinance, the San Francisco Fair Chance Ordinance, San Diego County Fair Chance Ordinance, and the California Fair Chance Act, where applicable, arrest or conviction records will be considered for Employment in accordance with these laws. At PwC, we recognize that conviction records may have a direct, adverse, and negative relationship to responsibilities such as accessing sensitive company or customer information, handling proprietary assets, or collaborating closely with team members. We evaluate these factors thoughtfully to establish a secure and trusted workplace for all.Applications will be accepted until the position is filled or the posting is removed, unless otherwise set forth on the following webpage. Please visit this link for information about anticipated application deadlines: https://pwc.to/us-application-deadlines

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