Director Provider Network Management jobs in United States
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Priority Health · 21 hours ago

Director Provider Network Management

Priority Health is focused on establishing and maintaining productive relationships with providers across various regions. The Director of Provider Network Management will oversee collaborative efforts with providers to identify improvement opportunities and implement action plans, while also providing strategic advice to executives regarding network expansion and performance issues.

Health Care
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H1B Sponsor Likelynote

Responsibilities

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
Oversee and direct collaborative efforts with providers in designated communities to identify improvement opportunities, develop action plans and successfully implement them
Direct the activities of the team, which many include Managers, as well as Sr. Provider Account Representatives and the Provider Account Representatives, 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 various risk arrangements, costs, cost-savings opportunities, best practices, provider performance issues, provider compensation and network expansion
Support market specific business needs for designated communities including attending slide presentations and providing market specific data and intelligence
Actively participates in safety initiatives and risk mitigating measures where appropriate and completes all position and unit safety related competencies and requirements on a timely basis
Performs other duties as assigned

Qualification

Provider network managementHealth care insuranceFinancial performance analysisManaged care knowledgeProvider reimbursement modelsStaff managementHealth care trendsCommunication skillsRelationship building

Required

Bachelor's Degree or equivalent in health care administration, business administration, accounting, finance, clinical or health and human services
5 years of relevant experience within provider network management, health care insurance or other health care delivery setting
5 years of relevant experience directly interacting with clinical practices, including experience analyzing and integrating financial and quality performance
LIC-Driver's License - STATE_MI State of Michigan Upon Hire

Preferred

Master's Degree (MBA, MHA, MHP)
5 years of relevant experience in direct management of staff
5 years of relevant experience Strong contextual knowledge related to managed care, provider reimbursement models, national health care trends and practice management

Benefits

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 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

Company

Priority Health

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Priority Health is an award-winning health benefits company.

H1B Sponsorship

Priority Health has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (6)
2024 (9)
2023 (9)
2022 (10)
2021 (5)
2020 (8)

Funding

Current Stage
Late Stage
Total Funding
$0.5M
Key Investors
Michigan Health Endowment Fund
2022-02-24Grant· $0.5M

Leadership Team

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Nick Gates
President
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Company data provided by crunchbase