Provider Network Manager

Job Description

Must be located in Ohio OR Michigan

A bit about this role:

This is a key role in our organization. This role will require a strong understanding of Medicare Advantage quality programs, including CMS STAR measures, with the ability to work collaboratively with providers to identify and close clinical care gaps, improve quality performance, and support initiatives that enhance member outcomes and overall plan performance. Additionally, this role will be responsible for network development and management along with servicing for an assigned geographic area. The ideal candidate will possess 5+ years experience in recruiting and managing provider networks along with negotiating, reviewing and amending contracts. This experience will include thorough knowledge of contracting with physicians and physician groups, integrated delivery systems, health systems, and ancillary providers using various payment methodologies including fe...