Provider Network Advisor

Corewell Health Corporate; Grand Rapids (MI); On-site; USD 90,000 - 130,000; Full time

Benefits offered by this job

Comprehensive benefits package

On-demand pay (Payactiv)

Discounts directory with deals

Identity theft protection, home and 64

Retirement options with employer match

Job summary

Corewell Health seeks a Provider Network Analyst to collaborate with cross-functional teams on network strategy, adequacy analysis, and project management initiatives. The role uses Quest Data Analytics and provider transparency data to assess performance and identify access opportunities while supporting expansion in Michigan, Indiana, and Wisconsin.

You will partner with leadership to improve operational efficiency, drive cost savings, ensure regulatory compliance, and enhance provider and

Qualifications

• Bachelor's degree or equivalent in contracting, finance, health administration, public health or related field.
• 10 years of relevant healthcare experience in Michigan.
• Master's degree or equivalent in health/public health analytics, informatics or related field.

Responsibilities

• Collaborate with cross-functional teams to support provider network strategy and governance.
• Perform network adequacy analysis and project management initiatives.
• Utilize Quest Data Analytics and provider transparency data to evaluate network performance.
• Support network expansion efforts across Michigan, Indiana and Wisconsin.

Education

Bachelor's Degree or equivalent in contracting, finance, health administration, public health or related field

Master's Degree or equivalent in related fields (public health, health administration, analytics, statistics, informatics, biostatistics, economics, math, engineering)

Job description

Job Summary

Collaborate with cross-functional teams and stakeholders across the organization to support provider network strategy, network adequacy analysis, and project management initiatives. This role will utilize Quest Data Analytics and provider transparency data to evaluate network performance, identify provider access opportunities, and support network expansion efforts in Michigan, Indiana, and Wisconsin. Partner with leadership on initiatives that improve operational efficiency, drive cost-saving opportunities, ensure regulatory compliance, and enhance provider and member satisfaction.

Essential Functions

Participants in developing and implementing Priority Health’s philosophy, mission, goals, and objectives that align with the strategic work plan for Provider Network. Organizes, coordinates and leads key initiatives that support the goals established by department leadership. This includes producing key decision point documents and strategic presentations. Recommends solution to business owner based on business problem and requirements. Solution considers project constraints of time and resources and may thus propose both short and long term options. Coordinates a group of related projects with the goal of completing projects on time and efficiently through the balancing of resources across the department and organization. Responsible for quality of deliverables.

Qualifications

Required Bachelor's Degree or equivalent in contracting, finance, health administration, public health or other related field 10 years of relevant experience within the healthcare industry in Michigan Preferred Master's Degree or equivalent In public health, health administration, analytics, statistics, informatics, biostatistics, economics, math, engineering, or other related field

About Corewell Health

As a team member at Corewell Health, you will play an essential role in delivering personalized health care to our patients, members and our communities. We are committed to cultivating and investing in YOU. Our top-notch teams are comprised of collaborators, leaders and innovators that continue to build on one shared mission statement - to improve health, instill humanity and inspire hope. Join a nationally recognized health system with an ambitious vision of continued advancement and excellence.

How Corewell Health cares for you

Learn more here.

• Comprehensive benefits package to meet your financial, health, and work/life balance goals.
• On-demand pay program powered by Payactiv
• Discounts directory with deals on the things that matter to you, like restaurants, phone plans, spas, and more!
• Optional identity theft protection, home and auto insurance
• Traditional and Roth retirement options with service contribution and match savings
• Eligibility for benefits is determined by employment type and status

Primary Location

SITE - Priority Health - 1239 E Beltline Ave NE - Grand Rapids Department Name Provider Network - PH Managed Benefits Employment Type Full time Shift Day (United States of America) Weekly Scheduled Hours 40 Hours of Work 8 a.m. to 5 p.m. Days Worked Monday to Friday Weekend Frequency N/A

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.

People are at the heart of everything we do, and the inspiration for our legacy of outstanding outcomes, innovation, strong community partnerships, philanthropy and transparency.

Corewell Health is a not-for-profit health system that provides health care and coverage with an exceptional team of 60,000+ dedicated people—including more than 11,500 physicians and advanced practice providers and more than 15,000 nurses providing care and services in 22 hospitals, 300+ outpatient locations and several post-acute facilities—and Priority Health, a provider-sponsored health plan serving more than 1.2 million members. Through experience and collaboration, we are reimagining a better, more equitable model of health and wellness.