Team Leader - Provider Network Contracting

Wellmark•Des Moines, IA

2d•Hybrid

About The Position

The Team Leader drives initiatives to develop, innovate, and maintain 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 in support of Wellmark and Blue Cross Blue Shield Association (BCBSA) programs. The position provides day-to-day leadership and management of team resources, including coaching, development, performance improvement, coordination, and budgeting. The Team Leader sets expectations and accountabilities, supports team growth, facilitates change, and fosters a positive work environment. The role also leads contracting initiatives, represents the department and corporation with external stakeholders, provides expertise on complex provider contract and network-status issues, and oversees contract language, policies, procedures, and related projects. This position follows a hybrid schedule, working at least three days per week in Wellmark’s Des Moines office, with the option to work remotely two days per week. Additional in-office days may be needed to meet business needs. The role requires a non-compete agreement.

Requirements

Bachelor’s degree or direct and applicable work experience.
At least five 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, with 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, including 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 presenting recommendations to varied audiences such as providers and adapting communication to the audience.
Ability to thrive in a dynamic environment and drive results through collaboration and effective partnership with different business areas.
Ability to work at least three days per week in Wellmark’s Des Moines office, with two remote days; additional office days may be required to meet business needs.
Must sign a non-compete agreement.
Must not require immigration sponsorship or additional work authorization, now or in the future, to work in the United States.

Nice To Haves

Bachelor’s degree.
Formal people-leadership experience.

Responsibilities

Provide leadership and day-to-day management of financial and human resources, with a focus on employee coaching, development, performance improvement, coordination, and budgeting for the team’s functions and services.
Support business objectives and deliver results that are effective, accurate, timely, and aligned with business and stakeholder needs.
Oversee Blue Distinction Centers, Care Sourcing, and other BCBSA contracting initiatives, leading collaboration with BCBSA and internal stakeholders to create, distribute, and maintain agreements.
Build relationships and partnerships with national providers, including durable medical equipment suppliers, laboratories, and air ambulance providers, to develop strategies for contracting agreements.
Lead activities supporting Wellmark’s network contracting policies, procedures, work instructions, and program manuals.
Represent the department and corporation on network contracting issues with 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, complicated provider contract and network-status issues.
Oversee the management and maintenance of provider contract language in collaboration with Legal.
Work with internal stakeholders to analyze provider network data and composition, assess network adequacy and customer needs, and recommend network expansions or contract changes.
Develop policies and procedures that document work instructions and business processes, including 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 collaboration with internal stakeholders, including Legal, the Blue Card team, and credentialing, to create, monitor, and maintain those contracts.
Lead department, division, and interdepartmental or interdivisional projects using process management tools and programs.
Perform other duties as assigned.