Director, Provider Network Strategy & Contracts

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 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.