Hybrid Value-Based Network Performance Leader

Wellmark-Blue-Cross-and-Blue-Shiel; Des Moines (IA); Hybrid; USD 90,000 - 130,000; Full time

Job summary

Wellmark Blue Cross Blue Shield is seeking a Network Performance Manager to develop and maintain strong relationships with health care organizations, physicians, and stakeholders. The role focuses on driving action plans, quality performance benchmarks, and total cost of care outcomes within value-based programs.

The successful candidate will balance analytical rigor with relationship management, delivering presentations to executives and adapting to diverse audiences while thriving in a

Qualifications

• Bachelor's degree or equivalent experience in healthcare or related field.
• 4+ years in healthcare with health quality data analysis and network management or provider relations.
• Ability to build relationships with internal and external stakeholders.
• Strong consultation, persuasion, and influencing skills.
• Excellent verbal and written communication with executives and stakeholders.
• Analytical, problem solving, and strategic thinking; willing to innovate.
• Self-starter, able to work independently and on teams.
• Strong organization and prioritization; manage multiple projects.
• Documentation of processes and procedures; decision-making following guidelines.
• Proficiency with Microsoft Office (Word, Excel, Outlook, PowerPoint, Access).
• Travel up to 10%; valid driver's license.

Responsibilities

• Develop and maintain relationships with key health care organizations, physicians, physician aggregators, and other stakeholders to drive action plans and value-based outcomes.
• Monitor and manage provider performance opportunities for total cost of care and quality benchmarks related to value-based initiatives.
• Conduct management committees and joint operating committee meetings and present as needed to review value-based contract compliance and performance.
• Negotiate value-based contractual relationships with health care organizations and stakeholders per Wellmark guidelines.
• Execute and implement new value-based models or changes to existing models with health care organizations.
• Assess external environment for value-based contracting and network performance implications; prepare information for decision-making.
• Serve as liaison to health care organizations regarding value-based contract issues and ensure alignment with network strategy.
• Support corporate initiatives related to engagement, quality, and efficiency of care; prioritize ongoing work.
• Other duties as assigned.

Skills

Relationship management

Healthcare data analysis

Verbal & written communication

Presentation skills

Project management

Analytical thinking

Negotiation

Time management

Microsoft Office

Education

Bachelor's degree or equivalent experience

Tools

Microsoft Office

Job description

Wellmark Blue Cross Blue Shield is seeking a Network Performance Manager to develop and maintain strong relationships with health care organizations, physicians, and stakeholders. The role focuses on driving action plans, quality performance benchmarks, and total cost of care outcomes within value-based programs.

The successful candidate will balance analytical rigor with relationship management, delivering presentations to executives and adapting to diverse audiences while thriving in a