Manager Provider Network Contracting

Corewell Health • Grand Rapids, MI

1d • Hybrid

About The Position

About Priority Health Priority 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 Role As 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 is a hybrid position requiring some on-site presence at one of our Priority Health facilities, offering flexibility and collaboration. What We’re 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

Requirements

• Bachelor's degree or equivalent in health care administration, business administration, accounting, finance, clinical or health and human services Required.
• Relevant experience in Provider contract negotiation in Michigan Required.
• 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.

Nice To Haves

• Master's degree, MBA, MHA, MHP Preferred.

Responsibilities

• 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.
• 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.

Benefits

• 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

What This Job Offers

• Job Type: Full-time
• Career Level: Manager