Team Leader Provider Network Contracting
Des Moines, IA - USA
Job Summary
Use your strengths at Wellmark!
About the Role: As a Team Leader you will drive initiatives that support the development innovation and maintenance of Wellmarks 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 Wellmarks network contracting 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 Wellmarks 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 will work a hybrid schedule of at least 3 days in Wellmarks Des Moines office with 2 days remote option. As a leader there may be additional days in the office to meet business needs.
Qualifications :
Preferred Qualifications - Great to have:
- Bachelors degree.
- Formal people-leadership experience.
Required Qualifications - Must have:
- Bachelors 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 teams 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 Wellmarks network contracting policies procedures work instructions and program manuals that support contracting functions.
e. Represent the department and corporation regarding issues pertaining to Wellmarks 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 Wellmarks provider networks to ensure they meet adequacy requirements and customers 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 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
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
About Company
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 memb ... View more