Director Provider Network Management

Grand Rapids, MI - USA

Monthly Salary: Not Disclosed

Posted on: 2 days ago

Vacancies: 1 Vacancy

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 Healths strategic objectives with delivery system initiatives to identify opportunities to create incentives to support quality improvement and cost reduction while improving patient satisfaction.

Essential Functions

Develop 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.

Qualifications

Required Bachelors Degree in health care administration business administration accounting finance clinical or health and human services
Preferred Masters Degree (MBA MHA MHP)
5 years of relevant experience within provider network management health care insurance or other health care delivery setting Required
5 years of relevant experience directly interacting with clinical practices including experience analyzing and integrating financial and quality performance Required
5 years of relevant experience in direct management of staff Preferred
5 years of relevant experience Strong contextual knowledge related to managed care provider reimbursement models national health care trends and practice management Preferred
LIC-Drivers License - STATEMI State of Michigan Upon Hire required

Physical Demands

Pallet to Waist (6 from floor) > 5 lbs: Seldom up to 10 lbs
Waist to Waist > 5 lbs: Seldom up to 10 lbs
Waist to Chest (below shoulder) > 5 lbs: Seldom up to 10 lbs
Waist to Overhead > 5 lbs: Seldom up to 10 lbs
Bilateral Carry > 5 lbs: Seldom up to 10 lbs
Unilateral Carry > 5 lbs: Seldom up to 10 lbs
Pushing Force > 5 lbs: Seldom up to 10 lbs
Pulling Force > 5 lbs: Seldom up to 10 lbs
Sitting: Frequently
Standing: Occasionally
Walking: Occasionally
Forward Bend - Standing: Seldom
Forward Bend - Sitting: Occasionally
Trunk Rotation - Standing: Seldom
Trunk Rotation - Sitting: Occasionally
Reach - Above Shoulder: Seldom
Reach - at Shoulder or Below: Seldom
Handling: Occasionally
Forceful Grip > 5 lbs: Seldom
Forceful Pinch > 2 lbs: Seldom
Finger/Hand Dexterity: Frequently

How Corewell Health cares for you

Comprehensive benefits package to meet your financial health and work/life balance goals. Learn more here.
On-demand pay program powered by Payactiv
Discounts directory with deals on the things that matter to you like restaurants phone plans spas and more!
Optional identity theft protection home and auto insurance pet insurance
Traditional and Roth retirement options with service contribution and match savings
Eligibility for benefits is determined by employment type and status

Primary Location

SITE - Priority Health - 1239 E Beltline - Grand Rapids

Department Name

Value Based and Affiliate Contracting - PH Managed Benefits

Employment Type

Full time

Shift

Day (United States of America)

Weekly Scheduled Hours

Hours of Work

8-5

Days Worked

M-F

Weekend Frequency

N/A

CURRENT 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 616.486.7447.

Required Experience:

Director

Job SummaryEstablish 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 He...