Demo

Manager Provider Network Contracting

Spectrum Health
Grand Rapids, MI Full Time
POSTED ON 1/15/2025
AVAILABLE BEFORE 4/9/2025

Job Summary

Responsible for leading and managing the provider contracting team to develop and maintain strong provider networks and contracts, including hospitals, physicians, and ancillary providers. Manage our standard contracts and standard contracting operating processes to ensure efficient operations. 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.
  • Maintain a comprehensive provider network (hospitals, physicians, ancillary) and ensure efficient standard contract processes and standard / negotiated contracting.
  • 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 interdepartmental committees throughout the organization. Collaborate with internal stakeholders to problem solve, process improve, information share, and to continuously improve provider contracting initiatives.

Qualifications

Required

  • Bachelor's Degree or equivalent in health care administration, business administration, accounting, finance, clinical or health and human services
  • 3 years of relevant experience within provider network management, health care insurance or other health care delivery setting.
  • 2 years of relevant experience directly interacting with clinical practices, including experience in analyzing and integrating financial and quality performance
  • 1 year of relevant experience leading projects, teams or initiatives
  • LIC - Driver's License - State of Michigan Upon Hire
  • Preferred

  • Master's Degree MBA, MHA, MHP
  • 3 years of relevant experience with direct management of staff
  • 3 years of strong contextual knowledge (managed care, provider reimbursement models, national health care trends, practice management trends)
  • About Corewell Health

    As a team member at Corewell Health, you will play an essential role in delivering personalized health care to our patients, members and our communities. We are committed to cultivating and investing in YOU. Our top-notch teams are comprised of collaborators, leaders and innovators that continue to build on one shared mission statement - to improve health, instill humanity and inspire hope. Join a nationally recognized health system with an ambitious vision of continued advancement and excellence.

    How Corewell Health cares for you

    Comprehensive benefits package to meet your financial, health, and work / life balance goals. Learn more .

    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 Contracting

    Employment Type

    Full time

    Shift

    Day (United States of America)

    Weekly Scheduled Hours

    Hours of Work

    8 to 5

    Days Worked

    Monday to Friday

    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

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