Manager Provider Network

JOB DESCRIPTION

About Priority HealthPriority 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.About the RoleAs 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.How Corewell Health cares for youComprehensive benefits package to meet your financial, health, and work/life balance goals. .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 Ave NE - Grand RapidsDepartment NameProvider Network Contracting - PH Managed BenefitsEmployment TypeFull timeShiftDay (United States of America)Weekly Scheduled Hours40Hours of Work8:00 a.m. - 5:00 p.m.Days WorkedMonday - FridayWeekend FrequencyN/ACURRENT COREWELL HEALTH TEAM MEMBERS – Please apply through Find Jobs from your Workday team member