Executive Leader, Managed Care & Compliance

ADP, Inc.; Portage (MI); On-site; USD 140,000 - 199,000; Full time

Job summary

This position is a senior executive role centered in Portage, MI, overseeing managed care operations, program integrity, compliance, customer services, and provider network management. The role ensures adherence to federal/state regulations, MDHHS contracts, and accreditation standards while driving access, accountability, quality, and transparency across the region.

The Chief Managed Care Officer reports to the CEO and leads cross-functional teams to manage complex contracts, regulatory

Qualifications

• Bachelor's in Business Administration, Public Health, Social Work, Law, Public Administration, or related field is required; JD or Master's strongly preferred.
• 8+ years of progressive leadership experience in managed care, Medicaid, or healthcare compliance.
• Deep knowledge of PIHP operations and complex contract terms.
• Ability to negotiate, interpret, and operationalize complex contracts into policy and practice.

Responsibilities

• Sets strategic direction for managed care functions in alignment with mission and obligations.
• Advises the CEO on operations, risk, and improvement opportunities.
• Leads cross-functional planning for regulatory changes, audits, and corrective actions.
• Oversees provider contracting, credentialing interfaces, and contract compliance.

Skills

Executive leadership

Regulatory compliance

Provider network management

Cross-functional collaboration

Education

Bachelor's degree in related field

Juris Doctor or Master's preferred

Tools

Microsoft Office 365

Job description

This position is a senior executive role centered in Portage, MI, overseeing managed care operations, program integrity, compliance, customer services, and provider network management. The role ensures adherence to federal/state regulations, MDHHS contracts, and accreditation standards while driving access, accountability, quality, and transparency across the region.

The Chief Managed Care Officer reports to the CEO and leads cross-functional teams to manage complex contracts, regulatory