Job Summary - Manager Provider Network PH

Cultivate 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 Functions - Manager Provider Network PHDevelop 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.Direct the activities of assigned team members, 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.Support market specific business needs in assigned communities including attending sales presentations and providing market specific data and intelligence.

Qualifications - Manager Provider Network PH

Required Bachelor's Degree or equivalent in health care administration, business administration, accounting, finance, clinical or health and human services, or similarPreferred Master's Degree MBA, MHA, MHP3 years of relevant experience within provider network management, health care insurance or other health care delivery setting.
Required2 years of relevant experience directly interacting with clinical practices, including experience in analyzing and integrating financial and quality performance Required1 year of relevant experience leading projects, teams or initiatives
Required3 years of relevant experience in direct management of staff
Preferred3 years of relevant experience Strong contextual knowledge (managed care, provider reimbursement models, national health care trends, practice management trends) PreferredLIC-Driver's License - STATE_MI State of Michigan Upon Hire required

Physical Demands - Manager Provider Network PH

Pallet 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: 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

PH - Provider Network Management

Employment Type

Full time

Shift

Day (United States of America)

Weekly Scheduled Hours

40

Hours of Work

8:00 a.m. to 5:00 p.m.

Days Worked

Monday through Friday

Weekend Frequency

N/A

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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.