Provider Programs Manager jobs in Michigan
Provider Programs Manager oversees the provider network administration function of an organization. Collects data, analyzes and reports on claims, utilization, costs and changes. Being a Provider Programs Manager reviews existing and future reimbursement policies, regulations and guidelines. Ensure competitiveness of provider network by the deployment of cost effective programs and systems that deliver results that meet cost control and quality goals of the organization. Additionally, Provider Programs Manager requires a bachelor's degree. Typically reports to a manager or head of a unit/department. The Provider Programs 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. Extensive knowledge of department processes. To be a Provider Programs Manager typically requires 5 years experience in the related area as an individual contributor. 1 to 3 years supervisory experience may be required. (Copyright 2024 Salary.com)
Recently Added Provider Programs Manager jobs
- Corewell Health
-
Grand Rapids, MI
FULL_TIME
-
The Sr. Provider Specialist in this role must be Certified Diabetes Care and Education Specialist (CDCES) . This role provides expert diabetes care, management, and education for Priority Health. An ideal candidate will have knowledge of healthcare plans. They will also be detail oriented, self-motivated and have
Microsoft Office experience.
Under general direction, is a liaison for health plan initiatives with physician hospital organizations (PHO), physician organizations (PO) state-wide and community entities. Partners with internal teams to develop and implement strategic initiatives. Manages and coordinates large multi-faceted projects in an organized and cost effective manner.
Essential Functions- Partner with internal teams and/or serve as a network/community liaison for strategic initiatives, training and Programs. This may include the assessment, analysis, planning, implementation and evaluation of multiple interventions, programs and data in support of Network efficiency, health outcomes and patient experience.
- Identifies, monitors, coordinates and manages multiple projects. This includes project scope, targets, timelines, resource requirements/costs, milestones and data requirements. Creates and prepares accompanying documents and reports.
- Coordinates the implementation of clinical pilots to ensure practice commitment to program goals and deadlines. Monitors results of pilot programs to ensure objective are achieved.
- Responsible for the analysis, review and dissemination of network performance information, including but not limited to financial, quality, utilization/satisfaction and/or disease specific.
- Develops and delivers or facilitates effective multi-media communication strategies, meetings, trainings and education materials for presentations with a variety of internal and external audiences.
- Serves as subject matter expert and resource for researching industry practices, sharing best practice and market surveillance information to internal and external customers.
- Certified Diabetes Care and Education Specialist (CDCES)
Qualifications- Required Bachelor's Degree
- Preferred Master's Degree
- 5 years of relevant experience in health plan, managed care or healthcare delivery, administration or clinical practice management. Required
- Knowledge of Facets Cactus, Health Information Technology and Business Objects. Preferred
- Knowledge of Health and Population Technology and Provider reporting. Preferred
- Certified Diabetes Care and Education certification required
- Proficient with Microsoft Office, PowerPoint and Excel
- GuidingCare software experience preferred
- RN License preferred
Physical Demands- Pallet to Waist (6" from floor) > 5 lbs: Seldom up to 10 lbs
- Waist to Waist > 5 lbs: Seldom up to 10 lbs
- Waist to Chest (below shoulder) > 5 lbs: Seldom up to 10 lbs
- Waist to Overhead > 5 lbs: Seldom up to 10 lbs
- Bilateral Carry > 5 lbs: Seldom up to 10 lbs
- Unilateral Carry > 5 lbs: Seldom up to 10 lbs
- Pushing Force > 5 lbs: Seldom up to 10 lbs
- Pulling Force > 5 lbs: Seldom up to 10 lbs
- Sitting: Frequently
- Standing: Occasionally
- Walking: Occasionally
- Forward Bend - Standing: Seldom
- Forward Bend - Sitting: Occasionally
- Trunk Rotation - Standing: Seldom
- Trunk Rotation - Sitting: Occasionally
- Reach - Above Shoulder: Seldom
- Reach - at Shoulder or Below: Seldom
- Handling: Occasionally
- Forceful Grip > 5 lbs: Seldom
- Forceful Pinch > 2 lbs: Seldom
- Finger/Hand Dexterity: Frequently
Primary Location
SITE - Priority Health - 1231 E Beltline - Grand RapidsDepartment Name
PH - Care Management - CommercialEmployment Type
Full timeShift
Day (United States of America)Weekly Scheduled Hours
40Hours of Work
8 a.m. to 5 p.m.Days Worked
Monday to FridayWeekend Frequency
N/ACURRENT COREWELL HEALTH TEAM MEMBERS – Please apply through Find Jobs from your Workday team member account. This career site is for Non-Corewell Health team members only.
Corewell Health is committed to providing a safe environment for our team members, patients, visitors, and community. We require a drug-free workplace and require team members to comply with the MMR, Varicella, Tdap, and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process, to perform the essential functions of a job, or to enjoy equal benefits and privileges of employment due to a disability, pregnancy, or sincerely held religious belief.
Corewell Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category.
An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity as we care for our patients, our communities, and each other. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do. We invite those that share in our commitment to join our team.
You may request assistance in completing the application process by calling 616.486.7447.
- 1 Month Ago
- ICNA RELIEF USA PROGRAMS INC
-
Hamtramck, MI
FULL_TIME
- Reporting to the CIO, the Marketing Manager will be responsible for leading ICNA Relief’s National Marketing strategy and monitoring digital presence on various technical/social media platforms. Imple...
- 16 Days Ago
- LTC Provider Care
-
Detroit, MI
FULL_TIME
- LTC Physician Care, PC is a new and emerging medical group dedicated to serving patients in the Skilled Nursing and Long-Term Care facility settings. Our goal is to improve the overall quality of care...
- 1 Month Ago
- District Manager
-
Flint, MI
FULL_TIME
- Description Using your past leadership experience, you will: Grow a portfolio of successful businesses: Develop district-level strategies to achieve each restaurant’s financial, operational and custom...
- 5 Days Ago
- LTC Provider Care
-
Clinton, MI
FULL_TIME
- LTC Physician Care, PC is a new and emerging medical group dedicated to serving patients in the Skilled Nursing and Long-Term Care facility settings. Our goal is to improve the overall quality of care...
- 1 Month Ago
- Community Housing Network
-
Troy, MI
FULL_TIME
- About Community Housing NetworkCommunity Housing Network (CHN) is a nonprofit organization committed to providing homes for people in need through proven strategies of homeless prevention, housing ass...
- 16 Days Ago
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-
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- Reef Systems
-
Eglin Afb, FL
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- CorVel
-
Fort Worth, TX
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-
Los Angeles, CA
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