Operations Jobs in Michigan

Position Description Summary:

Directs a multidisciplinary team managing and coordinating the business and contracting activities for the organization. Works with internal staff, and the Executive Director to develop and evaluate organizational strategies. Works in concert with clinical integration team to identify data needs to support program growth and achieve medical cost targets. Provides support to network physicians/providers.

Essential Function(s) of the Position:

1. Directs and coordinates the financial, analytic, and business activities of the operation.

2. Achieves organization targets through contracting as well as risk contract management.

3. Maintains all contracts, including understanding all financial incentives and other details needed for successful negotiations.

4. Provides recommendations and assists in transforming fee for service provider contracts into a value-based pricing model.

5. Monitors primary care and specialty risk arrangements for all payors to ensure organization and physician success.

6. Oversees data analytics department and develops specific actions to manage medical cost trend.

7. Identifies data and reporting solutions to support organization activities.

8. Assists in development of incentive programs based upon budget, and contract goals.

9. Supports established departmental policies and procedures, and quality programs.

10. Maintains professional growth and development and keeps abreast of latest special projects as assigned or directed.

11. Perform periodic analyses of the provider network from a cost, coverage, and growth perspective.

12. Represent the company at industry events and professional associations.

13. Oversee analysis of claim trend data and/or market information to derive conclusions to support contract negotiations.

14. Provides council for or takes disciplinary action to address staff performance deficiencies in accordance with GMP Network Human Resources policies and practices.

15. All other job duties as assigned. .

Education/Experience

Bachelor’s degree in business, economics, health care administration or related field. Master’s degree preferred.

Seven (7)-10 years of progressive professional leadership experience in a health care setting.

Licensing/Certifications:

Valid Michigan Driver’s License

Knowledge, Skills and Abilities:

• Business, Finance, Economics, and Healthcare Administration acumen
• Understanding of managed care contracting, risk and value-based contracting
• Strong verbal and written communication skills
• Ability to work collaboratively with all staff and develop plans in order to track, meet and exceed contract objectives
• Ability to maintain positive relationships with individuals of all levels
• Integrity to remain confidential on discussing private organization activities
• Proficient in Microsoft Office, including Word, Excel, and PowerPoint
• Demonstrated excellent interpersonal communication and presentation skills.
• Ability to communicate effectively with members of healthcare team.
• Effective oral and written communication skills.
• Excellent organizational skills and ability to independently manage workload

Job Type: Full-time

Pay: From $100,000.00 per year

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Health savings account
• Paid time off
• Vision insurance

Education:

• Bachelor's (Required)

Experience:

• Senior leadership: 5 years (Required)

Work Location: Hybrid remote in Clinton Township, MI 48038