Provider Network Strategy & Contracting Consultant

Use your strengths at Wellmark as our Provider Network Strategy & Contracting Consultant!   

About the opportunity: Youll play a critical hands-on role in advancing complex provider network agreements that support the organizations broader business strategy. This position is deeply involved in highlevel fee for service and valuebased negotiations significant contract drafting working in close partnership with Legal to translate business needs into wellstructured executable agreements. While leadership retains oversight and leads the most seniorlevel negotiations this role operates as the boots on the ground partner driving work forward progressing multiyear agreements preparing executivelevel materials and ensuring momentum from strategy through execution. Youll also collaborate closely with Network Contracting Network Performance and Network Payment Strategy teams to align contract terms with performance objectives business initiatives and our total cost of care strategy. 

About you: You bring strong experience in provider performance and network contracting with demonstrated capability in complex and valuebased negotiations. You bring a solid foundation in contract drafting and redlining along with confidence partnering closely with internal teams to resolve high-level issues to support business goals. The ideal candidate is comfortable working with analytics larger healthcare providers managing complex provider agreements influencing outcomes without relying on positional authority and working independently.  You bring experience supporting executive briefings collaborating across matrixed teams and translating strategy into actionable contracting work. Strong judgment strategic thinking attention to detail and the ability to balance negotiation strategy with operational followthrough are essential. Top candidates have health plan value-based performance and contracting experience. 

This position will work a hybrid schedule of at least 3 days (Tues-Thurs) in Wellmarks Des Moines office with two days (Mon/Fri) remote option. Business needs may require Mon/Fri in office weekly. 

Potential travel requirements: Approximately 10% 

Qualifications :

Preferred Qualifications - Great to have:

• Bachelors degree (if not already met through experience) with advanced education or specialized training in healthcare business or a related field a plus.
• Health plan value-based performance and contracting experience.

Required Qualifications - Must have:

• Bachelors degree or direct and applicable work experience.
• 5 years of progressive experience in provider network contracting demonstrating strong knowledge of contracting strategies contract setup and execution and applicable regulatory requirements within a healthcare environment.
• Advanced analysis negotiation influence and relationshipmanagement skills with the ability to execute complex provider contracting initiatives aligned to enterprise strategy and business objectives.
• Demonstrated ability to lead through expertise and influence providing guidance consultation and informal mentoring within crossfunctional and matrixed environments without direct peopleleader responsibility.
• Strong operational problemsolving and troubleshooting capabilities with the intellectual aptitude to understand healthcare industry dynamics evaluate complex issues and develop practical sustainable solutions.
• Highly developed criticalthinking skills with the ability to creatively apply data and insights to drive process improvements strategic alignment and positive business outcomes.
• Excellent written and verbal communication skills with the ability to clearly convey complex information recommendations and contracting considerations to a variety of audiences including providers and internal stakeholders adapting messaging as appropriate.
• Partners effectively with different business areas. Proven ability to succeed in a dynamic fastpaced environment driving results through collaboration and effective partnership with diverse business areas.
• Proven ability to succeed in a dynamic fastpaced environment driving results through collaboration and effective partnership with diverse business areas.

Additional Information :

What you will do:

a. Partners crossfunctionally to support the development and execution of Wellmark and BCBSA network strategies maintaining accountability for assigned contract initiatives and ensuring alignment with enterprise priorities.

b. Applies advanced analysis to evaluate network performance and design providerspecific contracting and methodology strategies while supporting the governance and continuous improvement of contracting policies procedures work instructions and program documentation.

c. Executes complex feeforservice and valuebased provider contract negotiations ensuring agreements align with Wellmarks quality financial and regulatory standards while supporting longterm network sustainability.

d. Leads the operational implementation of new and evolving valuebased payment models ensuring consistency with network strategy payment methodology and provider readiness.

e. Serves as a subject matter expert for escalated provider contract and network status issues providing expert guidance and resolution support to internal stakeholders.

f. Collaborates with internal partners to assess provider network composition and adequacy leveraging data and market insights to develop recommendations for network expansion optimization or contractual modifications.

g. Partners closely with Network Contracting Network Payment Strategy and Legal to support the drafting execution and maintenance of provider contracts and amendments ensuring accuracy consistency and compliance.

h. Applies advanced criticalthinking and problemsolving capabilities to evaluate complex issues assess alternatives and develop innovative datadriven solutions in collaboration with internal teams and external partners.

i. Manages multiple complex initiatives concurrently demonstrating strong organizational prioritization and execution skills in a dynamic and evolving business environment.

j. Builds and sustains effective provider relationships through proactive communication regarding contract initiatives changes and new opportunities ensuring clarity alignment and coordination across stakeholders.

k. Leads departmentlevel and crossfunctional initiatives using established business and processmanagement tools to support strategic execution and operational consistency.

l. Acts as a primary liaison with healthcare organizations on valuebased contracting matters ensuring alignment with contracting network payment strategy and enterprise objectives.

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

Please inform us if you meet the definition of a Covered DoD official.

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 

Wellmark supports and expects the responsible use of AI for our workforce! We welcome the responsible use of these tools by job seekers as well and are interested in learning from you; you will have an opportunity in the application process to share which tools you used and how you applied them. 

Remote Work :

No

Employment Type :

Full-time