Team Leader - Network Contracting

Wellmark, Inc.•Des Moines, IA

2d•Hybrid

About The Position

The Team Leader drives initiatives supporting the development, innovation, and maintenance of Wellmark’s network contracting strategy and oversees a comprehensive contract management database to improve the contracting experience for internal and external stakeholders. The role manages business processes to optimize network contracting performance and promotes collaborative relationships with health care organizations and across the department to support Wellmark and Blue Cross Blue Shield Association (BCBSA) programs. The position leads, coaches, and develops team members by setting expectations, defining accountabilities, facilitating change, and maintaining a positive work environment. It provides day-to-day management of team resources and functions, oversees contracting initiatives and agreements, and serves as a subject matter expert on provider contract and network-status issues. The role also represents the department and company to external stakeholders and leads projects and process improvements. This position follows a hybrid schedule, with at least three days per week in Wellmark’s Des Moines office and the option to work remotely two days per week. Additional office days may be needed to meet business needs. A non-compete agreement is required.

Requirements

Bachelor’s degree or direct and applicable work experience.
At least 5 years of progressively increasing experience in provider contract work, demonstrating expertise in provider network contracting strategies, setup, and regulations.
Advanced analysis, negotiation, influence, and relationship-management skills.
Formal or informal leadership experience and the ability to lead, coach, engage, and develop team members in a dynamic work environment.
Track record of setting team goals and achieving desired results.
Operational problem-solving and troubleshooting ability, with the aptitude to understand the industry and solve problems.
Strong analytical and critical-thinking skills; ability to think creatively and use data to drive positive outcomes and improvements.
Excellent written and verbal communication skills, including the ability to share recommendations with varied audiences, including providers, and adapt communication to the audience.
Ability to thrive in a dynamic environment and drive results through collaboration and effective partnerships across business areas.

Nice To Haves

Bachelor’s degree.
Formal people-leadership experience.

Responsibilities

Provide leadership and day-to-day management of financial and human resources, including employee coaching, development, performance improvement, coordination, and team budgeting.
Oversee Blue Distinction Centers, Care Sourcing, and other BCBSA contracting initiatives, coordinating agreements with BCBSA and internal stakeholders such as Legal, Network Administration, and Health Networks.
Build relationships with national providers, including durable medical equipment suppliers, laboratories, and air ambulance organizations, to develop contracting knowledge and strategies.
Lead and oversee activities supporting Wellmark’s network contracting policies, procedures, work instructions, and program manuals.
Represent the department and corporation on network contracting issues to external audiences, including health systems, hospitals, physicians, national health care organizations, BCBSA, and other stakeholders.
Serve as a subject matter expert and resource for internal departments resolving escalated provider contract and network-status issues.
Oversee provider contract language and collaborate with Legal on its management and maintenance.
Work with internal stakeholders to analyze provider network data and composition, assess network adequacy and customer needs, and recommend network expansion or contract changes.
Develop policies, procedures, and work instructions documenting business processes and steps to amend or add networks for Wellmark and BCBSA initiatives.
Coordinate communications about provider contracting initiatives and, with HCI leadership, develop provider relationships and communicate new contract opportunities or changes to existing contracts.
Oversee single case agreements and lead coordination with internal stakeholders, including Legal, the Blue Card team, and credentialing, to create, monitor, and maintain agreements.
Lead department, division, and interdepartmental or interdivisional projects using process management tools and programs.
Perform other duties as assigned.