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Director Provider Network Management
6 hours ago
Job Summary Establish 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 system initiatives to identify opportunities to create incentives to support quality improvement and cost reduction, while improving patient satisfaction. 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.Oversee and direct collaborative efforts with providers in designated communities to identify improvement opportunities, develop action plans and successfully implement them.Direct the activities of the team, which many include Managers, as well as Sr. Provider Account Representatives and the Provider Account Representatives, 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 various risk arrangements, costs, cost-savings opportunities, best practices, provider performance issues, provider compensation and network expansion.Support market specific business needs for designated communities including attending slide presentations and providing market specific data and intelligence.Actively participates in safety initiatives and risk mitigating measures where appropriate and completes all position and unit safety related competencies and requirements on a timely basis.Performs other duties as assigned.QualificationsRequired Bachelor's Degree in health care administration, business administration, accounting, finance, clinical or health and human servicesPreferred Master's Degree (MBA, MHA, MHP)5 years of relevant experience within provider network management, health care insurance or other health care delivery setting Required5 years of relevant experience directly interacting with clinical practices, including experience analyzing and integrating financial and quality performance Required5 years of relevant experience in direct management of staff Preferred5 years of relevant experience Strong contextual knowledge related to managed care, provider reimbursement models, national health care trends and practice management PreferredLIC-Driver's License - STATE_MI State of Michigan Upon Hire requiredPhysical DemandsPallet to Waist (6" from floor) > 5 lbs: Seldom up to 10 lbsWaist to Waist > 5 lbs: Seldom up to 10 lbsWaist to Chest (below shoulder) > 5 lbs: Seldom up to 10 lbsWaist to Overhead > 5 lbs: Seldom up to 10 lbsBilateral Carry > 5 lbs: Seldom up to 10 lbsUnilateral Carry > 5 lbs: Seldom up to 10 lbsPushing Force > 5 lbs: Seldom up to 10 lbsPulling Force > 5 lbs: Seldom up to 10 lbsSitting: FrequentlyStanding: OccasionallyWalking: OccasionallyForward Bend - Standing: SeldomForward Bend - Sitting: OccasionallyTrunk Rotation - Standing: SeldomTrunk Rotation - Sitting: OccasionallyReach - Above Shoulder: SeldomReach - at Shoulder or Below: SeldomHandling: OccasionallyForceful Grip > 5 lbs: SeldomForceful Pinch > 2 lbs: SeldomFinger/Hand Dexterity: FrequentlyHow Corewell Health cares for youComprehensive benefits package to meet your financial, health, and work/life balance goals. Learn more here.On-demand pay program powered by PayactivDiscounts directory with deals on the things that matter to you, like restaurants, phone plans, spas, and moreOptional identity theft protection, home and auto insurance, pet insuranceTraditional and Roth retirement options with service contribution and match savingsEligibility for benefits is determined by employment type and statusPrimary LocationSITE - Priority Health E Beltline - Grand RapidsDepartment NameValue Based and Affiliate Contracting - PH Managed BenefitsEmployment TypeFull timeShiftDay (United States of America)Weekly Scheduled Hours40Hours of Work8-5Days WorkedM-FWeekend FrequencyN/ACURRENT COREWELL HEALTH TEAM MEMBERS – Please apply through Find Jobs from your Workday team member account. This career site is for Non-Corewell Health team members only.Corewell Health is committed to providing a safe environment for our team members, patients, visitors, and community. We require a drug-free workplace and require team members to comply with the MMR, Varicella, Tdap, and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process, to perform the essential functions of a job, or to enjoy equal benefits and privileges of employment due to a disability, pregnancy, or sincerely held religious belief.Corewell Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category.An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity as we care for our patients, our communities, and each other. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do. We invite those that share in our commitment to join our team.You may request assistance in completing the application process by calling
