Manager Provider Network Contracting

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 talent and commitment of our employees. As part of the Corewell Health system, team members enjoy opportunities for career growth and advancement while maintaining seniority and benefits.

As Manager of Provider Network Contracting, you will partner with the Director to lead a team responsible for all of Priority Health’s 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.

• 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

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.
• Sustain a successful team and direct 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, and 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 continuously improve provider contracting initiatives.

• Bachelor’s degree or equivalent in health care administration, business administration, accounting, finance, clinical, or health and human services (Required).
• Master’s degree, MBA, MHA, or 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).

• Comprehensive benefits package to meet your financial, health, and work/life balance goals.
• On-demand pay program powered by Payactiv
• Discounts directory with deals on 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:

Priority Health - 1239 E Beltline Ave NE, Grand Rapids

Department: Provider Network Contracting - PH Managed Benefits

Employment Type: Full time

Shift: Day (United States of America)

Weekly Scheduled

Hours:

40

Hours of Work: 8:00 a.m. – 5:00 p.m.

Days Worked: Monday – Friday

Weekend Frequency: N/A

Corewell Health is committed to providing a safe environment and a drug-free workplace. We support reasonable accommodations for applicants with disabilities and follow equal employment opportunity practices. You may request assistance in completing the application process by calling .