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Director Provider Network Development Jobs in Michigan

Provider Network Manager

Allegan, MI · Hybrid

$70K - $97K/yr

The Provider Network Manager will coordinate the development of provider contracts with the Lakeshore Regional Entity. The Provider Network Manager will assist OnPoint executive leadership with the ...

New

We empower employees with curated development plans that foster growth and promote rewarding ... Knowledge of provider recruitment. * Experience balancing multiple priorities while meeting ...

Sup Network Analytics

Southfield, MI · On-site

$55K - $123K/yr

We empower employees with curated development plans that foster growth and promote rewarding ... Knowledge of provider recruitment. * Experience balancing multiple priorities while meeting ...

Started with the principle of providing outstanding service in identifying and delivering IT ... Standard best practices for network development and design. * Networking, Telephony and VoIP ...

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Director Provider Network Development information

What are some common challenges faced by a Director of Provider Network Development, and how can they be addressed?

A Director of Provider Network Development often encounters challenges such as negotiating favorable contracts with providers, ensuring network adequacy, and balancing cost control with quality of care. Successfully addressing these issues requires strong relationship-building skills, an in-depth understanding of healthcare regulations, and the ability to analyze market trends. Collaborating closely with legal, compliance, and analytics teams can help streamline contract negotiations and maintain a competitive, high-performing network. Continual professional development and staying current with industry changes are also key for long-term success in this role.

What is the difference between Director Provider Network Development vs Provider Network Manager?

AspectDirector Provider Network DevelopmentProvider Network Manager
CredentialsBachelor's degree, industry certifications often preferredBachelor's degree, relevant certifications beneficial
Work EnvironmentStrategic planning, high-level decision making, cross-department collaborationOperational management, provider relations, network oversight
Employer & Industry UsageHealth insurance companies, managed care organizationsHealth plans, healthcare providers, insurance firms
Search & Comparison IntentStrategic development, network expansion, leadership rolesOperational management, provider relations, network maintenance

The main difference is that the Director Provider Network Development focuses on strategic growth and high-level planning of provider networks, while the Provider Network Manager handles day-to-day operations and provider relations. Both roles require industry knowledge and relevant certifications, but their scope and responsibilities differ significantly.

What are the key skills and qualifications needed to thrive as a Director of Provider Network Development, and why are they important?

To thrive as a Director of Provider Network Development, you need a deep understanding of healthcare networks, contract negotiation, and provider relations, typically supported by a bachelor’s or master’s degree in healthcare administration or a related field. Familiarity with healthcare analytics platforms, provider management systems, and knowledge of payer-provider contract regulations are crucial. Strong leadership, relationship-building, and strategic communication skills set top performers apart. These competencies are vital for building robust provider networks, ensuring compliance, and driving organizational growth in a competitive healthcare environment.

What does a Director of Provider Network Development do?

A Director of Provider Network Development is responsible for building, maintaining, and optimizing relationships with healthcare providers, such as hospitals and physician groups, on behalf of insurance companies or health plans. They negotiate contracts, ensure providers meet quality and cost standards, and help expand the provider network to meet organizational goals. This role often involves analyzing network performance, identifying gaps in coverage, and collaborating with internal teams to improve service delivery and member satisfaction.
What are the most commonly searched types of Provider Network Development jobs in Michigan? The most popular types of Provider Network Development jobs in Michigan are:
What are popular job titles related to Director Provider Network Development jobs in Michigan? For Director Provider Network Development jobs in Michigan, the most frequently searched job titles are:
What cities in Michigan are hiring for Director Provider Network Development jobs? Cities in Michigan with the most Director Provider Network Development job openings:
Provider Network Manager

Provider Network Manager

OnPoint

Allegan, MI • Hybrid

$70K - $97K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted yesterday

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Job description

The role of OnPoint’s Provider Network Manager is to provide oversight and management of OnPoint’s contracted provider network, oversight of the organizational implementation of self-determined arrangements including the management of contractual relationships with financial management service providers, and the oversight of county of financial responsibility arrangements. The Provider Network Manager will coordinate the development of provider contracts with the Lakeshore Regional Entity. The Provider Network Manager will assist OnPoint executive leadership with the management of OnPoint’s network adequacy via development and maintenance of relationships with providers.

Pay Range:  

Salary: $70,428.80 - $97,198.40 annually

Benefits:

401(a) retirement: employer matching
  • 457 retirement
  • Paid holidays
Benefits effective date of hire:
  • Medical insurance
  • Dental insurance
  • Vision Coverage
  • Employer funding of Health Savings Account (up to elected deductible amount)
Employer Paid benefits:
  • Disability insurance
  • Life insurance (up to $50,000)
  • Paid Time Off

Flexible Work Conditions:     

  • Work at home, and in the office.   

Qualifications:   

  • Master’s degree required with Public Administration or Human Services field.

  • Independent worker with experience in dealing with people, businesses, and human services agencies.

  • 5 years experience with person-centered planning, self-determination, budget management, and a working knowledge of general business standards and practices.

  • Demonstrated ability to understand and apply Medicaid requirements and assist in providing training to service providers.

   Essential Functions:

*Reasonable accommodations may be made to enable individuals with disabilities to perform these essential functions.

  • Leads the development and/or revision of OnPoint’s contract management system in conjunction with other key organizational stakeholders with contract management responsibilities.

  • Oversees the development of assigned contracts in accordance with the organizational contract management system. The Provider Network Manager is responsible for the supervision of OnPoint’s Contract Specialist who assures that the OnPoint contracted providers are in compliance with their contract and the requirements set forth by regional, state, and federal guidelines.

  • Responsible for the development and maintenance of the OnPoint Provider Manual.

  • Responsible for the oversight of quality service provision within OnPoint’s contracted provider network including supervision of OnPoint’s Provider Network Quality Specialist.

  • Conducts research, analyzes data, and disseminates results on assigned administrative and programmatic topics.

  • Participates on committees and teams as requested or assigned within OnPoint and within the region.

  • Works with key internal and internal stakeholders including individuals served to expand the provider network and offer more choice and greater control to individuals served by OnPoint.

  • Oversees organizational implementation of self-determination including supervision of OnPoint’s Self Determination Coordinator. Responsible for assuring that OnPoint’s self-determined arrangements are compliant with requirements from the PIHP and MDHHS.

  • Oversees organizational County of Financial Responsibility (“COFR”) agreements and works closely with the OnPoint finance team and other Community Mental Health Service providers to assure timely and fiscally responsible execution of COFR agreements.

  • Oversees organizational credentialing of external providers to assure compliance with regional, state, and federal requirements.

  • Other duties as assigned

Equipment/Technology:    

  • Basic iPhone Knowledge  
  • Office 365 Skills  
  • Electronic Medical Record system

EEO Statement:

OnPoint is an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetic information, protected veteran status, sexual orientation, gender identity or expression, pregnancy, height, weight, or marital status, or any other characteristic protected by federal, state or local laws. 

Additional Information:

  • Must be eligible to work in the U.S. without sponsorship
  • Valid driver’s license may be required for local travel