Manager Provider Network
2 weeks ago
Manager of Provider Network ContractingPriority Health is Michigan's second-largest and fastest-growing health plan, dedicated to improving health and lives across the state. Our success as a nationally recognized nonprofit health benefits company is driven by the incredible talent and commitment of our employees. As part of the Corewell Health system, team members enjoy unique opportunities for career growth and advancement while maintaining seniority and benefits.As Manager of Provider Network Contracting, you will partner with the Director to lead a team of professionals responsible for all of Priority Health's hospital and physician contracting across the state of Michigan. This hybrid position requires on-site presence at our Grand Rapids facility two to three days per week, offering flexibility and collaboration.What We're Looking ForExperienced people leader with a background in healthcareProven ability to negotiate and manage complex contractsHighly organized and detail-orientedStrong communicator with excellent interpersonal skillsCollaborative leadership style focused on solutions and resultsScope of WorkResponsible for leading and managing the provider contracting team to develop and maintain strong provider networks and contracts. Negotiate health system and physician contracts. Lead a team of contracting professionals by providing guidance and performance management to achieve departmental goals. Engage with providers to promptly address any issues that arise. Cultivate and maintain productive relationships with providers. Coordinate and facilitate work with internal stakeholders, be solution focused, and develop process improvements. Evaluate cost, use, and quality performance to identify opportunities for improvement.Essential FunctionsDevelop and maintain purposeful, long-term relationships with providers based on fair and competitive business terms, with an emphasis on improving quality and the patients' experience of care, while reducing the cost of care.Manage improvement opportunities, develop action plans and successfully implement them.Support the contracting team in their contracts and negotiations, stepping in to negotiate when necessary.Sustains a successful team and directs the activities of assigned Contractors, establishing annual performance objectives and monitoring the interface between team members and network providers to ensure annual goals are achieved.Provide advice/guidance/recommendations to corporate and regional executives and business partners related to costs, cost-savings opportunities, best practices, provider performance issues, provider compensation and network expansion.Communicate internally and externally regarding provider related issues. Participate in key inter-departmental committees throughout the organization. Collaborate with internal stakeholders to problem solve, process improve, information share, and to continuously improve provider contracting initiatives.QualificationsBachelor's degree or equivalent in health care administration, business administration, accounting, finance, clinical or health and human services Required.Master's degree, MBA, MHA, MHP Preferred.Three years of relevant experience within provider network management, health care insurance or other health care delivery setting Required.One year of relevant experience leading projects, teams or initiatives Required.
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Manager Provider Network
3 weeks ago
Grand Rapids, United States Michigan Staffing Full timeManager Of Provider Network ContractingPriority Health is Michigan's second-largest and fastest-growing health plan, dedicated to improving health and lives across the state. Our success as a nationally recognized nonprofit health benefits company is driven by the incredible talent and commitment of our employees. As part of the Corewell Health system, team...
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Director Provider Network Management
3 weeks ago
Grand Rapids, United States Corewell Health Full timeProvider Network ManagerEstablish and maintain productive relationships with providers across geographic regions and/or large health care delivery systems. Understand market dynamics, including mergers and acquisitions, and delivery system expansion plans, including physician employment strategies. Link Priority Health's strategic objectives with delivery...
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Manager Network Management
2 weeks ago
Grand Rapids, United States Michigan Staffing Full timeJob Opportunity: Provider Network ManagementCultivate and maintain productive relationships with providers, healthcare executives, and healthcare teams in an effort to create an adequate, strong performing, and cost-effective network. Coordinate and facilitate work across medical management, provider operations, sales, and underwriting.Essential...
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Provider Relations Manager
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Grand Rapids, United States Molina Healthcare Full timeNetwork Provider Relations***Remote and must live in Michigan***Job SummaryMolina Health Plan Network Provider Relations jobs are responsible for network development, network adequacy and provider training and education, in alignment with Molina Healthcare's overall mission, core values, and strategic plan and in compliance with all relevant federal, state...
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Grand Rapids, United States Corporate Technologies, LLC. Full timeNetwork Administrator Corporate Technologies is a leading provider of managed IT solutions to businesses and institutions in Minnesota, Michigan, Kansas, Ohio, Florida, North Dakota, Southern California and New Jersey. With over 40 years of experience and more than 200 employees, Corporate Technologies provides Fortune 500 level IT support to small and...
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Case Manager
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Grand Rapids, MI, United States Hope Network Full timeThe Case Manager – Children’s Residential Services is a key associate at Hope Network whose primary responsibilities include: Coordinate all services necessary to maximize child’s success in treatment and growth in program. In residential settings, this position provides support to the clinician, staff and youth. Trauma informed approach is necessary....
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Grand Rapids, United States Hope Network Full timeCase Manager ClinicianWe are all equally human. Join us. At Hope Network, over , compassionate professionals serve individuals across + locations statewide—each playing a vital role in creating powerful comebacks. Whether through hands-on care or essential behind-the-scenes support, every team member contributes to a greater purpose: transforming lives....
