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Director Provider Network Management Jobs in Michigan

Zeeland Public Schools

Network Manager

Zeeland, MI · On-site

In conjunction with the Director of Educational Technology, the Network Manager will learn the needs of the district to provide network integrity and great customer service. Responsibilities: * Align ...

Zeeland Public Schools

Network Manager

Zeeland, MI · On-site

In conjunction with the Director of Educational Technology, the Network Manager will learn the needs of the district to provide network integrity and great customer service. Responsibilities: * Align ...

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All JobsProvider Network Management JobsDirector Provider Network Management JobsDirector Provider Network Management Jobs in Michigan

Director Provider Network Management information

See Michigan salary details

$47.7K

$114.7K

$229.3K

How much do director provider network management jobs pay per year?

As of Aug 29, 2026, the average yearly pay for director provider network management in Michigan is $114,706.00, according to ZipRecruiter salary data. Most workers in this role earn between $72,200.00 and $148,500.00 per year, depending on experience, location, and employer.

What does a director provider network management do?

A Director of Provider Network Management oversees the development and maintenance of healthcare provider networks for insurance companies, health plans, or healthcare organizations. They are responsible for negotiating and managing contracts with hospitals, physicians, and other healthcare providers to ensure quality care and cost-effectiveness. Their role also involves analyzing network performance, ensuring regulatory compliance, and leading a team to optimize provider relationships and network expansion.

What are the main challenges a director provider network management typically faces in maintaining provider relationships?

Directors of Provider Network Management often encounter challenges such as negotiating favorable contract terms, ensuring provider compliance with quality standards, and balancing cost containment with network adequacy. They must navigate complex regulatory requirements and address concerns from both providers and internal stakeholders. Building and maintaining positive relationships requires strong communication skills, as well as the ability to resolve disputes and align network strategies with organizational goals.

What are the key skills and qualifications needed to thrive as a director provider network management, and why are they important?

To thrive as a Director of Provider Network Management, you need deep knowledge of healthcare networks, contract negotiation, and provider relations, usually backed by a bachelor's or master's degree in healthcare administration or a related field. Familiarity with provider management systems, data analytics tools, and regulatory compliance platforms is typically required. Exceptional leadership, strategic thinking, and relationship-building skills help drive team performance and foster strong partnerships with providers. These abilities are crucial for optimizing network performance, ensuring regulatory compliance, and achieving organizational goals in a complex healthcare landscape.

What is the difference between Director Provider Network Management vs Provider Relations Manager?

AspectDirector Provider Network ManagementProvider Relations Manager
CredentialsHealthcare management, industry certificationsHealthcare or business-related certifications
Work EnvironmentStrategic planning, leadership, cross-department collaborationProvider communication, relationship building, contract negotiations
Employer & Industry UsageHealth insurance companies, managed care organizationsHealth plans, provider networks, healthcare organizations
Search & Comparison IntentHigh-level network management, strategic oversightProvider engagement, relationship management

The main difference is that the Director Provider Network Management oversees the entire provider network strategy and operations, focusing on high-level management and planning. In contrast, the Provider Relations Manager concentrates on maintaining and strengthening relationships with individual providers, handling day-to-day communication and negotiations.

What are the most commonly searched types of Provider Network Management jobs in Michigan?

The most popular types of Provider Network Management jobs in Michigan are:

What cities in Michigan are hiring for Director Provider Network Management jobs?

Cities in Michigan with the most Director Provider Network Management job openings:

Director Provider Network Management jobs near you
Infographic showing various Director Provider Network Management job openings in Michigan as of August 2026, with employment types broken down into 1% As Needed, 82% Full Time, 13% Part Time, 3% Contract, and 1% Nights. Highlights an 86% Physical, 4% Hybrid, and 10% Remote job distribution, with an average salary of $114,706 per year, or $55.1 per hour.

Director Network Performance & Engagement

Southfield, MI • On-site

RPMGlobal
See more jobs at RPMGlobalexternal

$150 - $210/hr

Other

Posted 13 days ago

Job description

Director Network Performance & Engagement Location Southfield, MI Primary Job Function Provider Network ID** 44987

Role Overview

The Director, Provider Network Performance & Engagement is responsible for leading strategies and initiatives to optimize provider network performance, advance value-based contracting, and strengthen provider relationships.

Work Arrangements
  • Hybrid – Associate must reside in Michigan (MI) and work onsite at the Southfield, MI office two days per week.
Responsibilities
  • Lead initiatives to monitor and improve provider performance, focusing on quality, efficiency, cost of care, and patient outcomes.
  • Responsible for development and execution of annual provider network strategy to include network adequacy standards, value-based strategies to drive and improve outcomes and engagement, and strategies to deliver a market-competitive network.
  • Analyze utilization and financial performance data to identify cost drivers and implement targeted interventions.
  • Oversight of VBP negotiations, VBP Contract performance, and leading VBP strategies in collaboration with internal stakeholders.
  • Monitor SCA and out-of-network utilization and trends, and develop contracting strategies to improve and increase in-network utilization.
  • Responsible for departmental staffing decisions and provides supervision to assigned staff, writing and performing annual reviews, and monitors performance issues as they arise.
  • Ensures department staff remain compliant in all aspects of Federal and State rules, regulations, policies, and procedures, and creates or modifies departmental policies to reflect changes.
  • Establish key performance indicators (KPIs) and regularly report on network performance to executive leadership.
  • Actively partners with the Market Director of Quality to drive Company-wide and Plan quality initiatives, such as Healthcare Effectiveness Data and Information Set (HEDIS), Consumer Assessment of Healthcare Providers and Systems (CAHPS), and National Committee for Quality Assurance/Utilization Review Accreditation Commission (NCQA/URAC), and analytics teams to ensure alignment on performance strategies.
  • Responsible for oversight of network adequacy monitoring and managing provider network, developing strategies to close gaps, and ensuring appropriate access to services throughout the Plan’s territory.
  • Oversight of large-scale provider terminations to include tracking, reporting, and identifying risks and strategies for gap closure and access.
  • Ensures provider contracts are consistent with organizational guidelines, claim payment methodologies, and state and federal regulatory requirements.
  • Ensures that non-standard contract elements are tracked and communicated to appropriate departments and obtains AHC and Plan approval before submission to the provider.
  • Responsible for leading complex negotiations for facilities and value-based contracts for clinically integrated networks.
  • Other duties as assigned.
Education & Experience
  • 5 or more years of provider contracting experience with various reimbursement models.
  • 10 or more years of healthcare strategy, provider relations, or network management.
  • Managed care experience preferred
Skills & Abilities
  • Strong knowledge of provider network management, provider contracting, and reimbursement methodologies.
  • Demonstrated experience developing and executing provider network strategies that support quality, cost, access, and performance goals.
  • Ability to lead value-based payment strategies, risk-sharing arrangements, and complex provider negotiations.
  • Strong analytical skills with the ability to interpret utilization, financial, quality, and network performance data.
  • Knowledge of network adequacy standards, access requirements, and state and federal managed care regulations.
  • Ability to identify cost drivers, performance gaps, and provider access issues and develop targeted improvement strategies.
  • Strong understanding of HEDIS, CAHPS, NCQA, and URAC quality standards.
  • Excellent leadership and people management skills, including staff supervision, performance management, and departmental planning.
  • Strong relationship-building skills with providers, executive leadership, internal departments, and external stakeholders.
  • Excellent written and verbal communication skills, including the ability to present complex information to executive audiences.
  • Ability to collaborate cross-functionally with quality, analytics, finance, operations, and compliance teams.

Strong problem-solving, decision-making, and strategic planning skills in a fast-paced managed care environment.

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