Director Provider Network Strategy and Contracting

Mclaren-Health-Care; Flint (MI); On-site; USD 150,000 - 210,000; Full time

Job summary

McLaren Health Plan is seeking a Director Provider Network Strategy & Contracting to lead the end-to-end provider network and contracting across Medicaid, Medicare and Commercial lines. The role drives affordability, quality and market performance in Michigan and surrounding markets.

The candidate will identify network gaps, guide expansions, manage cross-functional governance, and strengthen provider partnerships while ensuring regulatory readiness.

Qualifications

• Bachelor’s degree in business administration, healthcare administration, or related field.
• Eight years in provider network management or contracting; 3+ years in Medicaid/Medicare/MA-D SNP in multi-market roles.
• Valid state driver’s license, reliable transportation, and automobile insurance.
• Master’s degree in business administration, healthcare administration, or related field.
• Direct experience in Michigan managed care markets or integrated delivery systems.
• Familiarity with actuarial concepts, risk adjustment, and population health analytics.

Responsibilities

• Manage the health plan’s end-to-end provider network.
• Lead contracting strategy, affordability, and quality goals across Medicaid, Medicare, and Commercial lines.
• Ensure access, competitive positioning, and alignment with product and market objectives.
• Identify network gaps, analyze performance, and lead strategic contracting initiatives.
• Lead value-based and alternative payment arrangements; support new market entry; due diligence for expansion.
• Maintain strong provider partnerships and ensure regulatory readiness.
• Lead cross-functional governance across clinical, financial, and operational teams; monitor cost, utilization, and quality outcomes.
• Develop high impact provider engagement tools; anticipate regulatory shifts.

Skills

Provider network management

Provider contracting

Value-based payment

Government programs (Medicaid,Medicare

Supervisory leadership

Recruitment/training

Education

Bachelor’s degree in business administration/healthcare administration

Master’s degree in business/healthcare administration

Job description

McLaren Health Care, headquartered in Grand Blanc, Michigan, is a $7.3 billion, fully integrated health care delivery system committed to quality, evidence-based patient care and cost efficiency. The McLaren system includes 12 hospitals in Michigan, ambulatory surgery centers, imaging centers, a 640-member employed primary and specialty care physician network, commercial and Medicaid HMOs covering more than 732,838 lives in Michigan and Indiana, home health, infusion and hospice providers, pharmacy services, a clinical laboratory network and a wholly owned medical malpractice insurance company. McLaren operates Michigan’s largest network of cancer centers and providers, anchored by the Karmanos Cancer Institute, a National Cancer Institute-designated comprehensive cancer centers. McLaren has 20,000 full-, part-time and contracted employees and more than 113,000 network providers throughout Michigan, Indiana and Ohio.

Director Provider Network Strategy and Contracting

McLaren Health Plan (MHP) is a company with a culture of high performance and a mission to help people live healthier and more satisfying lives. We are looking for a Director Provider Network Strategy & Contracting, to join in leading the organization forward.

MHP is a Managed Care Organization dedicated to meeting the health care needs of each member. MHP offers multiple product lines, including individual and family plans, and Medicaid and Medicare plans to Michigan residents for every stage of life. McLaren Health Plan is accredited by the National Committee for Quality Assurance (NCQA).

MHP values the talents and abilities of all our employees and seeks to foster an open, cooperative and dynamic environment in which employees and the health plan can thrive. As an employee of MHP, you will be a part of a dynamic organization that considers all our employees as leaders in driving the organization forward and delivering quality service to all our members.

The Director of Provider Network Strategy & Contracting is responsible for managing the health plan’s end-to-end provider network. They are responsible for the overall contracting strategy, advancing affordability and quality goals, and driving competitive market performance across the Medicaid, Medicare, and Commercial lines of business. This role is responsible for ensuring access, competitive positioning, and alignment with product and market objectives. They identify network gaps, analyze network performance, and lead strategic contracting initiatives that strengthen the plan’s market presence. This leadership position is responsible for all value-based and alternative payment arrangements, supporting new market entry, conducting due diligence to guide expansion decisions, maintaining strong provider partnerships, and ensuring the network is positioned to support growth, differentiation, and regulatory readiness. This position is responsible for leading cross functional governance across the clinical, financial, and operational teams, ensuring that network strategy aligns with affordability, quality, and performance priorities. They monitor provider network performance across cost, utilization, and quality outcomes, develop high impact provider engagement tools, and anticipate regulatory and industry shifts to keep the organization ahead of market change.

Qualifications:

Required:

Bachelor’s degree in business administration, healthcare administration, or related field.

Eight (8) years of experience in provider network management, provider contracting, or value-based payment (VBP) to include three (3) years of experience in government programs (Medicaid, Medicare, MA/D SNP) while leading multi-market provider contracting or network development programs with at least three (3) years in a supervisory role leading or assisting in all phases of effective supervision (i.e. Recruitment, performance management, training).

• Valid state driver’s license, reliable transportation, and automobile insurance coverage required and maintained throughout employment.

Preferred:

Master’s degree in business administration, healthcare administration, or related field.

• Direct experience in Michigan Managed Care markets and/or integrated delivery systems.
• Familiarity with actuarial concepts, risk adjustment, and population health analytics.

Additional Information

• Schedule: Full-time
• Requisition ID: 26010295
• Daily Work Times: 8:30 AM - 5:00 PM
• On Call: No

Equal Opportunity Employer

McLaren Health Care is an Equal Opportunity Employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sexual orientation, gender identification, age, sex, marital status, national origin, disability, genetic information, height or weight, protected veteran or other classification protected by law.