Manager, Health Provider Network
Motion Picture Industry Pension & Health PlansLos Angeles, CA
Full Time Job
Motion Picture Industry Pension & Health Plans (MPI) has a new opportunity for a Manager, Provider Health Network. This newly created position will be responsible for overseeing utilization of network referrals, review and resolve referral requests, manage the referral platform, and perform/arrange provider training to newly credentialed Narrow Network providers. Keys to success in this role include an understanding of utilization review and medical claims, as well as knowledge of Healthcare Common Procedure Coding System (HCPS) and ICD-10.
For consideration, qualified candidates only, submit a letter of interest with salary requirements and resume.
* Bachelor's degree in related field or equivalent work experience
* Three years' experience with Utilization Review preferred
* Five years' management experience preferred
* Strong knowledge of CPT/HCPCS and ICD-10 codes preferred
* Anthem Blue Cross Utilization Review and claims experience is highly preferred
* Demonstrated ability to utilize and apply the general and specialized principles, practices, techniques, and methods of utilization management
* Working knowledge of regulatory requirements and accreditation standards
* Intermediate to advanced skills with Windows, Excel, and Outlook
* Excellent written and verbal communication skills
* Ability to work overtime/extended hours as required
Your responsibilities would include:
* Supervising, training, and developing a team that includes both customer service and administrative staff
* Coordinate and manage Narrow Network referral authorization process and system platform that is within MPI.
* Serve as liaison for Participant's and Narrow Network providers.
* Perform or arrange provider training to newly credentialed Narrow Network providers and Staff on referral Platform.
Submissions will be reviewed; only candidates most closely matching the requirements of the position will be contacted.
Local candidates only, relocation assistance is not provided.
MPI does not file visa petitions or sponsor applicants for work visas in this job classification.
Located in Studio City, CA, the Motion Picture Industry Pension and Health Plans (MPI) are multi-employer trust funds established by collective bargaining agreements between various employers and over 30 Unions and Guilds representing employees in the motion picture industry.
Recognized as an Employer of Choice for its employee-focused work environment, competitive compensation and benefits, MPI is a recipient of the World at Work Seal of Distinction.
MPI offers free employee health, dental, vision, and life insurance ($50/month for family coverage), retirement and pension, and generous paid time off.
Equal Opportunity Employer
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