Supervisor Network Mgmt & Compliance (Hybrid/Jackson, MI) - Mosaic CIN

This position is a hybrid role, requiring at least one day a week in Jackson, MI.

GENERAL SUMMARY:

Provides operational leadership to network membership, compliance oversight and provider data accuracy across the clinically integrated network. Oversees staff responsible for implementing network enrollment, credentialing support, compliance monitoring, and provider record maintenance. Collaborates with leadership to prioritize and manage network participation requirements and regulatory obligations, ensuring effective planning, continuous improvement, and workflow management. Works closely with providers and cross-departmental experts to ensure providers meet organizational, contractual and regulatory standards in support of a compliant, high-quality network.

• PRINCIPLE DUTIES AND RESPONSIBILITIES:

Oversee daily activities of staff responsible for network membership processing, provider onboarding/maintenance and compliance-related workflow execution.

Works with departmental leadership to prioritize implementation of network participation requirements, credentialing and enrollment support activities and compliance initiatives and manages timelines and workflows to meet departmental targets.

• Accomplishes performance results through strong operational effectiveness, including planning, continuous improvement methodology, process and outcome evaluation, workflow management and implementation support for network operations, compliance processes, and provider data management functions.
• Fosters relationships and collaborates with providers and other cross-departmental subject matter experts to resolve complex enrollment or network status issues and ensure accurate, compliant provider participation.
• Promotes the advancement of network membership accuracy, regulatory compliance, and maintenance of network standards by network-participating providers across all service types.
• Works closely with leadership and staff to ensure participating providers comply with network, payor, and governmental programs, policies, and standards.
• Recruits and develops talent; communicates job expectations; monitors, and appraises job results; coaches, counsels, and manages staff performance; and develops and enforces systems, policies, procedures, and productivity standards.
• Interacts and communicates effectively with committee and board members, network and health system leadership, providers, practice managers, community partners, management, and staff.

EDUCATION/EXPERIENCE REQUIRED:

• Bachelor's degree in health sciences, Business, Health Care Administration, or related field.
• Three (3) years of experience in managed care, clinically integrated network, or other provider organization, or other relevant experience supporting value-based care or network operations.
• Experience spanning cross-functional areas in medical practices, health plans and/or in complex healthcare delivery systems preferred.
• Management/supervisory experience in clinically integrated network or related setting preferred.
• Demonstrated strong operational leadership skills including developing and implementing systems to hardwire processes, drive accountability, delegate and communicate performance expectations and apply prioritization and proactive problem-solving to ensure systems run smoothly and efficiently.
• Demonstrated knowledge and understanding of healthcare industry, hospital systems, health plans and managed care including provider enrollment, credentialing standards, and regulatory compliance expectations for network participation.
• Demonstrated effectiveness working in a complex and rapidly changing industry with multiple entities and constituencies, communicating, collaborating, interacting, and collaborating effectively with patients, staff, public, providers and departments.
• Demonstrated excellent interpersonal, motivational, organizational, communication skills, customer service orientation, and strong physician relationships.
• Strong computer, database, analytical and evaluation skills.
• Understanding of provider data systems, network reporting and compliance tracking tools.

Additional Information

• Organization: Corporate Services
• Department: HF CIN
• Shift: Day Job
• Union Code: Not Applicable