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Spectrum Health B0022E - Sr. Provider Performance Specialist in Southfield, Michigan

CURRENT SPECTRUM HEALTH TEAM MEMBERS – Please apply through Find Jobs from your Workday team member account. This career site is for Non-Spectrum Health team members only.

Job Description

Job Summary

Advance the requirements of business and performance improvement plans for assigned Accountable Care Networks and large practice groups. Develop and implement network engagement strategies linking strategic goals to the execution and renewal of contracts, evaluating cost and quality performance of specific providers and health systems, and identifying opportunities for improvement.

Essential Functions

  • Responsible for contributing to the development of the Network Engagement Strategy for assigned Accountable Care Networks. Substantially responsible for the execution of the strategy, including implementation of an annual business plan; coordinating and managing overall activities and developing strategies and approaches to help providers maximize performance potential

  • Analyze and monitor Accountable Care Networks performance to ensure the achievement of financial and clinical outcomes. Manage projects and implement strategies pertinent to complex Accountable Care Networks.

  • Actively contribute to the InterDisciplinary Teams to ensure successful engagement of all parties

  • Participate in the development and administration of payment programs, aligning economics with the business strategy to achieve lower per capita cost

  • Manage and implement special programs related any element of the Network Engagement Strategy necessary to achieve the objectives of an individual Accountable Care Network or the company as a whole

  • Work closely with Network Development to support access and expansion initiatives

Qualifications

  • Required Bachelor's Degree in health care administration, business administration, accounting, finance, clinical or health and human services or equivalent education and experience

  • Preferred Master's Degree Master’s degree in health care administration or business administration or other relevant degree

  • 5 years of relevant experience of either provider network management experience, health care insurance or other health care delivery setting Required

  • 2 years of relevant experience directly interacting in a clinical environment Preferred

  • Proven experience analyzing and assimilating financial and outcomes data Preferred

  • Knowledge of Patient Profiles and RPX reporting, and/or other reporting programs Preferred

  • Experience delivering presentations to a variety of audiences Preferred

  • Intermediate level knowledge of Microsoft Office Suite Preferred

Primary Location

SITE - American Center - 27777 Franklin Rd - Southfield

Department Name

PH - Provider Contracting

Employment Type

Full time

Shift

Day (United States of America)

Weekly Scheduled Hours

40

Hours of Work

40

Days Worked

8

Weekend Frequency

N/A

Accommodation Notice: If you are a qualified individual with a disability, you may request a reasonable accommodation in Spectrum Health's application process. Contact us at 616-486-SHHR (7447).

Spectrum 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, sexual orientation, veteran status, or any other legally protected

category. See more here (https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf) .

Who We Are

Spectrum Health is a nationally recognized not-for-profit health system, offering a full continuum of health services through our health plan, medical group and hospital group. As an integrated health system, we are able to work together across all facilities, employees and providers to create exceptional, consumer-focused interactions.

Spectrum Health is redefining what it takes to improve the health of our communities and introducing new and innovative ways for consumers to access high-quality, low-cost care so that they can connect with us for a lifetime of health.

We strive to provide one Spectrum Health experience: a consistent, high-quality, seamless health journey for consumers; no matter where, when or how they interact with us. The result is better health outcomes for the thousands of individuals, families and communities we serve.

We are the region’s largest employer, with corporate offices located in Grand Rapids, Michigan. Spectrum Health Hospital Group and Spectrum Health Medical Group are consistently recognized for the exceptional care they provide. Priority Health is among the largest health system-sponsored health plans in the U.S. and offers extensive experience serving large and small employer groups, individuals, Medicare Advantage, Healthy Michigan Plan and Medicaid populations.

Since 2010, Spectrum Health has been listed five times among the 15 Top Health Systems in the U.S. by Truven Analytics™. Click here (https://www.spectrumhealth.org/about-us/quality-safety-and-patient-experience/awards) to see a complete list of our safety, quality and patient experience awards.

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