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From Home Provider Network Development Jobs in Michigan

Quantum Infotech

Network Engineer

Troy, MI · On-site

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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From Home Provider Network Development information

What is a from home provider network development professional?

A From Home Provider Network Development job involves building and maintaining relationships with healthcare providers, such as doctors and hospitals, to expand or improve a healthcare network. Professionals in this role typically work remotely and are responsible for recruiting providers, negotiating contracts, and ensuring compliance with regulations. Their goal is to create a strong, accessible network that meets the needs of health plan members. This position requires skills in communication, negotiation, and knowledge of healthcare systems. Remote work allows for flexibility while still achieving important network development goals.

How does a from home provider network development professional typically collaborate with healthcare providers and internal teams?

As a remote Provider Network Development professional, you will regularly coordinate with healthcare providers through virtual meetings, emails, and phone calls to negotiate contracts and ensure compliance with network standards. Internally, you will work closely with credentialing, legal, and provider relations teams using collaboration tools such as shared databases and project management software. Effective communication and proactive outreach are essential to overcome the challenges of remote work and maintain strong professional relationships. You may also participate in regular virtual team meetings to align on goals, share updates, and resolve issues collaboratively.

What are the key skills and qualifications needed to thrive as a from home provider network development professional, and why are they important?

To excel as a Provider Network Development professional working remotely, you need a solid understanding of healthcare provider relations, contract negotiation, and network management, often supported by a degree in healthcare administration or a related field. Familiarity with provider databases, CRM software, and managed care systems is typically required. Strong communication, relationship-building, and self-motivation are vital soft skills for effective remote collaboration and provider engagement. These abilities ensure efficient network growth, quality provider relationships, and organizational success in a virtual environment.

What is the difference between From Home Provider Network Development vs From Home Provider Relations Specialist?

AspectFrom Home Provider Network DevelopmentFrom Home Provider Relations Specialist
CredentialsHealthcare administration, network management certificationsCustomer service, healthcare communication certifications
Work EnvironmentRemote, healthcare provider offices, corporate officesRemote, healthcare provider offices, corporate offices
Employer & Industry UsageHealth insurance companies, managed care organizationsHealth insurance companies, healthcare providers
Search & Comparison IntentBuilding and managing provider networksMaintaining provider relationships and resolving issues

From Home Provider Network Development focuses on creating and expanding healthcare provider networks, requiring skills in network management and healthcare administration. In contrast, From Home Provider Relations Specialist emphasizes maintaining provider relationships and addressing provider concerns. Both roles are essential in healthcare organizations but differ in their primary focus and responsibilities.

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 From Home Provider Network Development jobs in Michigan?

For From Home Provider Network Development jobs in Michigan, the most frequently searched job titles are:

What job categories do people searching From Home Provider Network Development jobs in Michigan look for?

The top searched job categories for From Home Provider Network Development jobs in Michigan are:

What cities in Michigan are hiring for From Home Provider Network Development jobs?

Cities in Michigan with the most From Home Provider Network Development job openings:

From Home Provider Network Development jobs near you

Provider Network & Contract Manager

Kalamazoo, MI • On-site

Senior Care Partners PACE
Health Care and Social Assistance • 51 - 200 employees
Learn more about Senior Care Partners PACEexternal

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Re-posted 19 days ago

Job description

Provider Network and Contracts Manager
The Program of All-Inclusive Care for the Elderly (PACE) offers a variety of services, with many of them provided onsite at a PACE Center.
PACE is an alternative to nursing home care and – through an interdisciplinary care team (IDT) of physicians, nurse practitioners, nurses, social workers, therapists, van drivers, and aides – coordinates and provides preventive, primary, acute, and long-term care services, so older individuals can continue living in the community.
Why You'll Love it Here:
  • Purpose
  • Professional Development
  • Paid Holidays
  • PTO and SIck Time
  • Internal opportunities for growth
  • Team Support
  • Competitive Pay
  • Medical, Dental, Vision Insurance
  • Life insurance
  • 403(b) Retirement Savings
  • Employee Assistance
  • And MORE!
Why You’ll Love Working Here

  • Meaningful work with a purpose

  • Professional development opportunities

  • Paid holidays + generous PTO

  • Flexible, team-oriented culture

  • Competitive pay amp; great benefits: Medical, Dental, Vision, Life Insurance, Telemedicine

  • 403(b) retirement savings plan

Primary Purpose
Responsible for managing provider network operations, including provider contracting, credentialing, compliance, and relationship management. Ensures a high-quality, compliant provider network that supports participant care and aligns with Federal, State, and organizational requirements.

Key Responsibilities
  • Develop, negotiate, and manage provider contracts and network relationships.
  • Ensure provider network adequacy, credentialing compliance, and adherence to CMS and MDHHS requirements.
  • Monitor provider performance, conduct audits, and manage corrective action plans.
  • Educate and onboard providers regarding organizational policies, procedures, and the PACE model of care.
  • Maintain provider network data, contract documentation, and related policies and procedures.
  • Collaborate with internal departments and external partners to support service delivery, quality outcomes, and value-based care initiatives.
  • Resolve provider and contract-related issues while maintaining high customer service standards.
  • Participate in quality improvement, compliance reviews, and regulatory audits.
Leadership Responsibilities
Provides functional leadership for Provider Network and Contract operations. Serves as the primary coordinator for provider contracting, compliance, and credentialing activities while working closely with the Contract Coordinator and cross-functional teams.
Qualifications
  • Bachelor’s degree in business administration, Healthcare Administration, or other applicable experience degree required
  • 3 to 5 years of contracting / insurance / healthcare experience
  • Strong working knowledge of Medicare and Medicaid billing requirements
  • Knowledge of PACE and Medicare Advantage Plans preferred
Additional Requirements
  • Must be fully vaccinated or willing to become vaccinated against:
    Influenza, MMR, Varicella, Tdap/Td, COVID-19, and Hepatitis B
  • Must meet CMS competency standards prior to working independently
  • Comfortable working in varied home environments and all weather conditions

Join Us!

If you’re ready to do meaningful work in a place where you feel you truly belong, where partnership drives every interaction, and where excellence and ownership guide how we care for our participants and one another, we invite you to apply. Senior Care Partners PACE is proud to be an Equal Employment Opportunity employer.

Apply