Manager-Provider Network Management • CMHAM - Community Mental Health Association of Michigan
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Manager-Provider Network Management

Agency Name: Region 10 PIHP

Agency Contact: HR

  • Position Type: Full Time
  • Job Type: Permanent
  • County: St. Clair
  • Salary Range: 60,000 per Year
  • Send applications to: https://Secure.YourPayrollHR.com/ta/TPC0161.careers?ShowJob=503562640
  • Please include your resume when applying.

$1500 Sign-On Bonus available
Overview: Region 10 is committed to being a premier employer by enhancing the lives of our team and supporting their growth as people and professionals. We provide competitive wage scales that reward experience and performance, ongoing career development and training opportunities, excellent health coverage, generous paid time off with additional performance-based incentives, 12 paid holidays, flexible scheduling, and a comprehensive benefit program. The health and safety of our staff is a top priority, and we have implemented a COVID 19 preparedness and response plan to ensure this.

If you are looking for rewarding and meaningful work within a supportive, high-performing team in a positive, enthusiastic environment, we encourage you to apply at:
https://www.region10pihp.org/about-us/employment-opportunities/
ESSENTIAL FUNCTIONS
The Manager – Provider Network Management is an administrative position with responsibility in providing direction for provider network management activities for the provider organizations that deliver public behavioral health services in the counties of Genesee, Lapeer, Sanilac, and St. Clair and their contract agencies.
• Provide training, guidance, and support to the Network Management Team and Network Providers.
• Chair the PIHP Provider Network Committee and Privileging & Credentialing Committee.
• Member of the Quality Improvement Committee.
• Review Privileging and Credentialing initial and renewal applications and manage process for tracking, notifications, and updates.
• Provide support for External Auditing Bodies, reviewing document submissions, providing presentations, and recommendations on Corrective Action Plans.
• MDHHS EGrAMS Project Director.
• Manage administrative and service provider contracts.
• Manage Liability insurance coverage.
• Policy and Procedure development and ongoing review.
• Manage Medicaid bulletin and proposed policy reviews.
• Team lead for contract monitoring.
• Manage procurement activities included requests for proposals.
• Manage provider manual development.
• Report development.
• Supervision of Network Management staff.

MINIMUM QUALIFICATIONS (AN EMPLOYEE MUST HAVE THE FOLLOWING CREDENTIALS, TRAINING, AND EXPERIENCE)

• Bachelor’s Degree in behavioral health or related field
• Experience in the area of Contracts or Provider Network Management
• Two years of experience supervising staff
• Experience working at Pre-Paid Inpatient Health Plan (PIHP) and / or Community Mental Health (CMH)
• Experience in writing reports, analyzing data and administrative projects
• Ability to be a “work leader” (of a person or function), or advise others
• Experience in managing projects and teams
• Excellent organizational and writing skills
• Demonstrated knowledge of Microsoft Word and Excel
• Ability to exercise some flexibility in problem solving, when expected results are clear and generally set by others, provided certain outcomes are avoided
• Ingenuity is required to adapt, alter, or improvise alternatives when unexpected situations occur
• Ability to exercise discretion and some flexibility in selecting an optimal solution from established alternatives to obtain the desired outcome
• Ability to use or exert influence in a work process
• Ability to provide, exchange or explain information which conveys an opinion or evaluation of the facts or analyses
• Ability to develop and/or maintain effective work relationships with new, established, or non-receptive individuals/organizations through tact, diplomacy, and persuasion
• Basic knowledge of MDHHS reporting
• Basic knowledge of State of Michigan Medicaid Provider Manual
• Valid State of Michigan Driver’s License
• Must have access to transportation

PREFERRED QUALIFICATIONS

• Master’s Degree in behavioral health or related field
• Five years of experience supervising staff
• Five years of experience working with a Pre-Paid Inpatient Health Plan (PIHP)
• Experience in privileging and credentialing
• Experience with Microsoft PowerPoint
• Advanced knowledge of MDHHS reporting
• Advanced knowledge of State of Michigan Medicaid Provider Manual

(517) 374.6848

507 S. Grand Avenue, Lansing, MI  48933

 

 

CMHA is an equal opportunity employer and service provider. CMHA celebrates diversity and is committed to creating an inclusive environment for all employees, partners, and those whom CMHA serves. CMHA does not discriminate in employment nor in the provision of services on the basis of race, color, religion, sex (including pregnancy and gender identity), national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an employee organization, parental status, or other non-merit factor.

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