Provider Network Manager

TL;DR

Provider Network Manager (Healthcare): Managing and developing provider networks for Medicare Advantage plans with an accent on CMS STAR measures and clinical quality performance. Focus on negotiating provider contracts, identifying clinical care gaps, and collaborating with internal teams to improve member outcomes.

Location: Must be located in Ohio or Michigan

Salary: $80,000 - $110,000 / year

Company

hirify.global is an all-in-one healthcare company dedicated to improving the well-being of older Americans through integrated insurance, clinical care, and technology.

What you will do

• Develop, maintain, and manage an adequate provider network within the assigned geographic area.
• Negotiate and renegotiate contracts with physicians, health systems, and ancillary providers.
• Collaborate with providers to identify and close clinical care gaps and improve CMS STAR measure performance.
• Monitor performance dashboards and reporting tools to track quality indicators and HEDIS metrics.
• Partner with internal quality, clinical, and analytics teams to translate data insights into actionable provider strategies.
• Maintain strong provider relationships and ensure compliance with all network requirements.

Requirements

• Must be located in Ohio or Michigan
• 5+ years of experience in negotiating provider contracts, including value-based and risk-sharing models.
• Proven experience in provider relations and network management.
• Deep understanding of CMS STAR measures and quality improvement initiatives.
• Proficiency with Google or MS Suite.
• Unrestricted driver's license for required travel within the assigned territory.

Culture & Benefits

• Employer-sponsored health, dental, and vision plans with low or no premiums.
• Generous paid time off and parental leave program.
• Stock options for all employees.
• 401K program with company contributions.
• $100 monthly mobile or internet stipend.
• Commitment to a diverse, inclusive, and supportive work environment.