Team Leader - Provider Network Contracting

Wellmark, Inc.; Des Moines (IA); Hybrid; USD 90,000 - 135,000; Full time

Job summary

Wellmark, Inc. in Des Moines, IA is seeking a Team Leader to drive the development and maintenance of the network contracting strategy and the contract management database.

You will lead a team, partner with stakeholders, and ensure contracting processes align with Wellmark and BCBS Association programs. You will coach and develop team members, manage budgeting and performance, and collaborate with Legal, Health Networks and providers to optimize contracts and expand networks while ensuring

Qualifications

• Bachelor's degree or direct and applicable work experience.
• 5+ years of progressively increasing experience in provider contract work that demonstrates expertise with provider network contracting strategies, setup, and regulations.
• Advanced analysis, negotiation, influence, and relationship management skills.
• Proven formal or informal leadership experience; ability to lead, coach, engage, and develop team members in a dynamic work environment.
• Operational problem solving/troubleshooting with the ability to understand industry and solve problems.

Responsibilities

• Provide leadership and day-to-day management of financial and human resources for the team.
• Oversee Blue Distinction Centers, Care Sourcing, and other contracting initiatives with internal stakeholders.
• Build relationships with National Providers to develop contracting strategies.
• Lead team to support network contracting policies, procedures, and program manuals.
• Represent department and organization to external audiences including health systems and providers.
• Serve as SME and escalate provider contract issues as needed.
• Oversee provider contract verbiage collaboration with Legal.
• Analyze provider networks to meet adequacy and customer needs and develop expansion recommendations.
• Develop policy and procedure documentation for work instructions and processes.
• Coordinate communication about contracting initiatives with internal and external partners.
• Oversee single case agreements and collaborate with internal stakeholders.
• Lead interdepartmental projects using process management tools.

Skills

Provider contract expertise

Leadership experience

Analytical skills

Negotiation skills

Communication skills

Education

Bachelor's degree or equivalent experience

Job description

• Full-time
• Department: Clinical | Health Networks | Provider Support
• Pay Grade: 24

Company Description

Why Wellmark: We are a mutual insurance company owned by our policy holders across Iowa and South Dakota, and we’ve built our reputation on over 80 years’ worth of trust. We are not motivated by profits. We are motivated by the well-being of our friends, family, and neighbors-our members. If you’re passionate about joining an organization working hard to put its members first, to provide best-in-class service, and one that is committed to sustainability and innovation

Learn more about our unique benefit offerings here .

Job Description

Use your strengths at Wellmark!

About the Role:As a Team Leader, you will drive initiatives that support the development, innovation and maintenance of Wellmark's network contracting strategy, as well as oversight of a comprehensive contract management database with a goal of improving the contracting experience for all internal and external stakeholders. This role is responsible for effectively managing business processes to optimize the performance of Wellmark's network contracting functions. In addition, you will promote strong, collaborative and cohesive relationships with health care organizations and across the department to support the delivery of Wellmark and Blue Cross Blue Shield Association (BCBSA) programs.

About You:As a leader of others, you will directly impact the success, growth, and development of team members by setting clear expectations, defining accountabilities, providing regular coaching, facilitating change, and providing an overall positive work environment. Being a role model in behaviors that demonstrate Wellmark’s Leader Success Expectations is a must. You are passionate about driving team performance and executing and supporting growth and development of your team.You are a strong change leader who demonstrates both flexibility and resiliency. You are at your best when you can strategically think both upstream and downstream, use data to inform decisions, and creatively solve problems – plus, you love to inspire and coach others to do the same. You thrive in a dynamic, fast-paced environment where you can partner with multiple stakeholders to deliver optimal results.Prior formal people-leadership experience highly preferred.

This position willworka hybrid schedule of at least 3 days in Wellmark's Des Moines office, with 2 days remoteoption.As a leader, theremay beadditionaldays in the office to meet business needs.

Qualifications

Preferred Qualifications - Great to have:

Required Qualifications - Must have:

• Bachelor's degree or direct and applicable work experience.
• 5+ years of progressively increasing experience in provider contract work that demonstrates expertise with provider network contracting strategies, setup, and regulations.
• Advanced analysis, negotiation, influence, and relationship management skills.
• Proven formal or informal leadership experience; ability to lead, coach, engage, and develop team members in a dynamic work environment. Track record of success setting team goals and achieving desired results.
• Operational problem solving/trouble shooting - intellectual aptitude to understand industry and solve problems
• Strong analytical and critical thinking skills. Thinks creatively and uses data to drive positive outcomes and improvements.
• Excellent written and verbal communications skills with the ability to share recommendations with varying audiences, including providers. Adapts communication based on audience.
• Proven ability to thrive in a dynamic environment and drive results through collaboration. Partners effectively with different business areas.

Additional Information

What you will do:

• a. Provide leadership and day-to-day management of financial and human resources, primarily focusing on employee coaching, development, performance improvement, coordination, and budgeting for the team’s specific functions/services. Support business objectives and produce results that are effective, accurate, timely, and on target to meet business and stakeholder needs.
• b. Provide oversight to Blue Distinction Centers, Care Sourcing, and other BCBSA contracting initiatives and leads the team to work with BCBSA and internal stakeholders (legal, network administration, health networks) to create, distribute, and/or maintain the agreements for these initiatives.
• c. Build relationships and facilitate partnership with National Providers, i.e., durable medical equipment (DME) suppliers, laboratories, air ambulance, and others to develop Wellmark knowledge and creation of strategies to leverage in contracting agreements.
• d. Lead team and oversee activities that support Wellmark’s network contracting, policies, procedures, work instructions and program manuals that support contracting functions.
• e. Represent the department and corporation regarding issues pertaining to Wellmark’s network contracting to external audiences including health systems, hospitals, physicians, national health care organizations, Blue Cross Blue Shield Association, and other stakeholders.
• f. Serve as a subject matter expert and resource for internal departments when complicated provider issues pertaining to contracts and network status need to be escalated for resolution.
• g. Oversee the management and maintenance of provider contract verbiage, including collaboration with Legal.
• h. Work collaboratively with internal stakeholders to analyze the data and composition of Wellmark’s provider networks to ensure they meet adequacy requirements and customer’s needs and develops recommendations regarding the expansion of the networks and/or changes to our contracting agreements.
• i. Policy and procedure development to document work instructions, business processes, steps to amend or add networks to support Wellmark and BCBSA initiatives.
• j. Coordinate communication about provider contracting initiatives. In partnership with HCI leadership, develops relationships with providers and communicates new contract opportunities or changes to existing contracts.
• k. Provide oversight of single case agreements and leads the team to partner with internal stakeholders (legal, blue card team, credentialling) to create, monitor and maintain the unique contracts.
• l. Lead key department/division and interdepartmental/interdivisional projects through the effective use of process management tools and programs.
• m. Other duties as assigned.

This job requires a non-compete agreement.

An Equal Opportunity Employer

The policy of Wellmark Blue Cross Blue Shield is to recruit, hire, train and promote individuals in all job classifications without regard to race, color, religion, sex, national origin, age, veteran status, disability, sexual orientation, gender identity or any other characteristic protected by law.

Applicants requiring a reasonable accommodation due to a disability at any stage of the employment application process should contact us at [e-mail]

At this time, Wellmark is not considering applicants for this position that require any type of immigration sponsorship (additional work authorization or permanent work authorization) now or in the future to work in the United States. This includes, but IS NOT LIMITED TO: F1-OPT, F1-CPT, H-1B, TN, L-1, J-1, etc. For additional information around work authorization needs please refer to the following resources: Nonimmigrant Workers and Green Card for Employment-Based Immigrants

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