Director - Provider Network Contracting

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, consider applying today! 

Learn more about our unique benefit offerings here. 

Job Description

About the opportunity:  Wellmark’s Director of Provider Network Contracting will provide leadership and strategic direction for Wellmark’s highest level of provider network contracting initiatives and negotiations with overall accountability and leadership of program prioritization, strategic planning, and execution of complex provider agreements. They will partner cross‑functionally with Network Contracting, Network Payment Strategy, Provider Relations, Payment Integrity, Legal, Operations, and other business areas to design and implement contracting and provider payment strategies that support network cost of care, quality and outcomes performance and long‑term sustainability. In addition, they will oversee sophisticated provider network initiatives that mitigate risk, improve quality and affordability for members, and ensure adherence to contract performance and enterprise outcomes. They will also promote teamwork and strong collaborative relationships in a highly matrixed environment, facilitating the successful cohesion of all department functions and across the organization.

Use your strengths at Wellmark: Our ideal candidate will have strong knowledge of the healthcare landscape and extensive experience with hospital, physician, and other health care organizations payment and contracting strategies, specifically fee-for-service and value-based arrangements, shared savings/shared risk, and financial incentive models, and network performance for commercial and government lines of business. Top candidates will have large-scale, high-impact experience negotiating provider network contracts.

Our strongest candidates believe health care can be better, and they are passionate about finding ways to influence this important work. They have well-rounded network strategy and contracting experience. They are analytical, innovative, and partner effectively internally and externally using their strong communication skills. From design to implementation and maintenance - they bring structure to ideas. The challenge of working with others to achieve a more advanced shared-savings model is work that excites them.  

This position will work a hybrid schedule of at least 3 days (Tues-Thurs) in Wellmark’s Des Moines office with 2 days remote option (Mon/Fri). As a Director, you may be in-office on Mondays and Fridays periodically to meet business needs.

Qualifications

Preferred Qualifications - Great to have:

• Master’s degree.
• Business and industry acumen.
• Prior experience leading people-leaders.
• Experience leading high-impact provider network negotiations.

Required Qualifications - Must have:

• Bachelor's degree or direct and applicable work experience.
• 7+ years of experience in the healthcare industry, with focus on provider contract work that demonstrates a track record of success and expertise with provider network contracting strategies, setup, and regulations, or related industry experience. This includes experience in roles focused on commercial, value-based arrangements, relationship management (e.g., physician, hospital), strategic consultation, and analysis of data/information. Additional experience in network analytics and network performance preferred.
• Strong negotiation, influence, and relationship management skills with strong emotional intelligence and business aptitude to understand industry and solve problems.
• Experience interpreting network analytics, quality and clinical outcomes, claims data, and trends to understand provider utilization trends and determine benchmarks.
• Proven track record delivering and demonstrating superior negotiating, communication, and critical thinking skills. Strong understanding of principles and practices of contract negotiation and administration, including an in-depth understanding of complex contract provisions.
• Formal leadership experience with the proven ability to lead, coach, engage, and develop team members in a dynamic, changing and matrixed work environment. Track record of success setting team goals, aligning resources effectively, and achieving