PROVIDER NETWORK MANAGER jobs in Dearborn, MI

PROVIDER NETWORK MANAGER manages the network of healthcare providers to ensure effective operations and coverage of services. Researches and collects information to evaluate healthcare providers and assist with network development. Being a PROVIDER NETWORK MANAGER manages, reviews, and renews contracts with healthcare providers, evaluating terms, expectations, and compliance with organizational policies and regulatory requirements. Facilitates positive relations with providers, acting as a primary point of contact, resolving questions and concerns, and providing support and resources to ensure services meet standards. Additionally, PROVIDER NETWORK MANAGER recruits, hires, and trains staff and oversees credentialing. Requires a bachelor's degree. Typically reports to a director. The PROVIDER NETWORK MANAGER manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. To be a PROVIDER NETWORK MANAGER typically requires 5 years experience in the related area as an individual contributor. 1-3 years supervisory experience may be required. Extensive knowledge of the function and department processes. (Copyright 2024 Salary.com)

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Manager: Provider Network Management Department
  • Region 10
  • Port Huron, MI FULL_TIME
  • Essential Functions

    The Manager of the Provider Network Management Department is an administrative position with responsibility in providing direction for provider network management activities for the provider organizations that deliver public behavioral health services in the counties of Genesee, Lapeer, Sanilac, and St. Clair and their contract agencies.

    • Provide training, guidance, and support to the Network Management Team and Network Providers.
    • Chair the PIHP Provider Network Committee and Privileging & Credentialing Committee.
    • Member of the Quality Improvement Committee.
    • Review Privileging and Credentialing initial and renewal applications and manage process for tracking, notifications, and updates.
    • Provide support for external audits including reviewing document submissions, providing presentations, and developing recommendations on Corrective Action Plans.
    • Manage provider contracts.
    • Oversee Policy and Procedure development and ongoing review.
    • Manage Medicaid bulletin and proposed policy reviews.
    • Oversee process for monitoring provider service contracts.
    • Manage procurement activities including requests for proposals.
    • Supervision of Provider Network Management staff.
  • 22 Days Ago

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Director Provider Network Management - HAP
  • Health Alliance Plan
  • Troy, MI FULL_TIME
  • The Director, Provider Network Management (PNM) with Health Alliance Plan (HAP), will be responsible for provider contracting and management of provider relations for assigned accounts using a coordin...
  • 1 Month Ago

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Director Provider Network Management - HAP
  • HAP - Henry Ford Health - Careers Careers
  • Troy, MI FULL_TIME
  • The Director, Provider Network Management (PNM) with Health Alliance Plan (HAP), will be responsible for provider contracting and management of provider relations for assigned accounts using a coordin...
  • 1 Month Ago

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Administrative Coordinator Provider Network Management
  • Region 10
  • Port Huron, MI FULL_TIME
  • Essential Functions The Administrative Coordinator is an administrative position that works under the general direction of the PIHP Administrative Director on provider network management activities re...
  • 1 Month Ago

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Restaurant Manager
  • Restaurant General Manager
  • Warren, MI FULL_TIME
  • Burger King believes in the importance of flexibility for employers and employees alike, and we believe that our employees are our greatest asset. We treat our people with respect and honesty and are ...
  • 15 Days Ago

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Network Supply Planning Manager
  • Henkel
  • Warren, MI FULL_TIME
  • At Henkel, you can build on a strong legacy and leading positions in both industrial and consumer businesses to reimagine and improve life every day. If you love challenging the status quo, join our c...
  • Just Posted

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0 PROVIDER NETWORK MANAGER jobs found in Dearborn, MI area

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Contracts Lead - I75
  • DRAGADOS
  • Detroit, MI
  • Principal/Essential Duties & Responsibilities * Request and submit prime contract documents, bonds, and insurance certif...
  • 9/19/2024 12:00:00 AM

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Restoration Supervisor
  • SERVPRO of Oak Park/Ferndale
  • Ferndale, MI
  • Benefits SERVPRO of Oak Park/Ferndale offers: Competitive compensation Superior benefits Career progression Professional...
  • 9/19/2024 12:00:00 AM

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Manager, Behavioral Health Programs
  • ACCESS
  • Dearborn, MI
  • Job Title: Manager, Behavioral Health Programs Job Status: Full-time **COVID-19 VACCINATIONS: Highly recommended for all...
  • 9/19/2024 12:00:00 AM

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Director of Philanthropy and Grants
  • City of Dearborn, MI
  • Dearborn, MI
  • Salary : $100,000.00 - $110,000.00 Annually Location : Dearborn 48126, MI Job Type: Full time Job Number: 11032 Departme...
  • 9/17/2024 12:00:00 AM

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Manager, Organizational Change Management
  • Ford
  • Dearborn, MI
  • Job Description We are the movers of the world and the makers of the future. We get up every day, roll up our sleeves an...
  • 9/17/2024 12:00:00 AM

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Smallwares Manager
  • Restaurant Depot
  • Dearborn, MI
  • Smallwares Manager FULL-TIME $17.50/hr Working closely with Branch Manager to ensure efficient operation of the Smallwar...
  • 9/17/2024 12:00:00 AM

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UX Program Manager
  • Ford
  • Dearborn, MI
  • Job Description We are the movers of the world and the makers of the future. We get up every day, roll up our sleeves an...
  • 9/16/2024 12:00:00 AM

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Project Manager
  • Bond Brand Loyalty
  • Dearborn, MI
  • About Us: At Bond, we craft innovative solutions with the aim of forging stronger brand loyalty and building sustainable...
  • 9/16/2024 12:00:00 AM

According to the United States Census Bureau, the city has a total area of 24.5 square miles (63 km2), of which 24.4 square miles (63 km2) is land and 0.1 square miles (0.26 km2) (0.37%) is water. The city developed on both sides of the Rouge River. An artificial waterfall/low head dam was constructed by Henry Ford on his estate to power its powerhouse. The Upper, Middle, and Lower Branches of the river come together in Dearborn. The river is widened and channeled near the Rouge Plant to allow lake freighter access. Fordson Island (42°17′38″N 83°08′52″W / 42.29389°N 83.14778°W / 42.29389; -...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for PROVIDER NETWORK MANAGER jobs
$112,819 to $145,625
Dearborn, Michigan area prices
were up 1.2% from a year ago

PROVIDER NETWORK MANAGER in Lafayette, LA
NCQA Provider Network Accreditation creates a framework for organizations to provide efficient, accurate and consistent network management and credentialing services.
December 25, 2019
PROVIDER NETWORK MANAGER in Saginaw, MI
A crucial part of this effort is educating our providers about our plans, particularly our insurance benefits and workers’ compensation plans, and how to navigate the claims process for each one.
February 21, 2020
PROVIDER NETWORK MANAGER in Elkhart, IN
We offer providers a value-based reimbursement model centered on aligning quality measures, HEDIS measures and HH incentives to reward high-quality care of the members you serve.
January 03, 2020