Provider Network Strategy & Contracting Consultant at Wellmark Inc

Des Moines, Iowa, United States -

Full Time

Start Date

Immediate

Expiry Date

06 Aug, 26

Salary

0.0

Posted On

08 May, 26

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Provider Network Contracting, Value-Based Negotiations, Contract Drafting, Network Strategy, Relationship Management, Healthcare Analytics, Strategic Thinking, Operational Problem-Solving, Cross-functional Collaboration, Executive Briefing, Fee-for-Service Negotiations, Regulatory Compliance

Industry

Insurance

Description

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 Use your strengths at Wellmark as our Provider Network Strategy & Contracting Consultant! About the opportunity: You’ll play a critical, hands-on role in advancing complex provider network agreements that support the organization’s broader business strategy. This position is deeply involved in high‑level, fee for service and value‑based negotiations, significant contract drafting, working in close partnership with Legal to translate business needs into well‑structured, executable agreements. While leadership retains oversight and leads the most senior‑level negotiations, this role operates as the “boots on the ground” partner driving work forward, progressing multi‑year agreements, preparing executive‑level materials, and ensuring momentum from strategy through execution. You’ll 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 value‑based 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 follow‑through 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 Wellmark’s 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: Bachelor’s 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: Bachelor's 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 relationship‑management 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 cross‑functional and matrixed environments, without direct people‑leader responsibility. Strong operational problem‑solving and troubleshooting capabilities, with the intellectual aptitude to understand healthcare industry dynamics, evaluate complex issues, and develop practical, sustainable solutions. Highly developed critical‑thinking 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, fast‑paced environment, driving results through collaboration and effective partnership with diverse business areas. Proven ability to succeed in a dynamic, fast‑paced environment, driving results through collaboration and effective partnership with diverse business areas. Additional Information What you will do: a. Partners cross‑functionally 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 provider‑specific contracting and methodology strategies, while supporting the governance and continuous improvement of contracting policies, procedures, work instructions, and program documentation. c. Executes complex fee‑for‑service and value‑based provider contract negotiations, ensuring agreements align with Wellmark’s quality, financial, and regulatory standards while supporting long‑term network sustainability. d. Leads the operational implementation of new and evolving value‑based 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 critical‑thinking and problem‑solving capabilities to evaluate complex issues, assess alternatives, and develop innovative, data‑driven 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 department‑level and cross‑functional initiatives using established business and process‑management tools to support strategic execution and operational consistency. l. Acts as a primary liaison with healthcare organizations on value‑based 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 [email protected] 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. Department: Clinical | Health Networks | Provider Support Work Environment: Hybrid Pay Grade: 24

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Responsibilities

The role focuses on advancing complex provider network agreements and executing high-level fee-for-service and value-based negotiations. It involves partnering with Legal and Network Strategy teams to translate business needs into executable contracts and operational payment models.