Manager Provider Network

About Priority Health
Priority Health is Michigans 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 Role
As Manager of Provider Network Contracting you will partner with the Director to lead a team of professionals responsible for all of Priority Healths 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 Were Looking For

• Experienced people leader with a background in healthcare
• Proven ability to negotiate and manage complex contracts
• Highly organized and detail-oriented
• Strong communicator with excellent interpersonal skills
• Collaborative leadership style focused on solutions and results

Scope of work

Responsible 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 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.
• 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.

Qualifications

• Bachelors degree or equivalent in health care administration business administration accounting finance clinical or health and human services Required.
• Masters 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 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

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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.