Director - Provider Network Contracting

What you will do

• a. Lead and direct complex provider network contract negotiations, serving as the primary strategist and decision-maker for high-value, complex provider agreements. Develop negotiation strategies that balance affordability, quality, risk mitigation, and network sustainability while aligning stakeholder interests, achieving enterprise objectives, and ensuring favorable contractual and financial outcomes for Wellmark. b. Provide leadership and day-to-day management of financial and human resources, primarily focusing on employee and leader coaching, development, performance improvement, coordination and budgeting for multiple staff, and department specific functions/ services. Cascade and communicate strategy and initiatives to team members, driving customer/stakeholder service, and supporting achievement of overall company results. c. Provide leadership in evaluating and developing strategic plans that support expansion or change within the network to meet company goals and objectives. Partner with all areas of the Network team for all commercial and government networks and products. d. Leverages the analysis and interpretation of claim trends, network performance metrics, and market intelligence to inform contracting strategies, support network cost management, and influence data‑driven decision making; partners cross‑functionally to resolve complex business, financial, and technical challenges. e. Partner closely with key stakeholders and share Wellmark’s provider network contracting strategies for commercial and government programs networks as appropriate to ensure a partnership and complete understanding of the business rationale for the decisions, obtaining feedback before finalizing plans, which ensures long term goals and measures are consistent with strategies and objectives for network development and product growth. f. Develop and drive implementation of large-scale complex provider network strategies for payers across the markets to include network development and expansion planning, network design, network performance optimization, commercial value-based payment models, provider initiatives, and provider data operational efficiencies. g. Represent both the department as well as Wellmark, regarding issues pertaining to network contracting and payment strategy, including fee for service and commercial value-based payment models, to external audiences including health systems, hospitals, physicians, national health care organizations, BCBSA, and other stakeholders. h. Serve as a subject matter expert and key thought leader for internal departments when complicated provider issues pertaining to contracts and network status need to be escalated for resolution. i. Partner with other key stakeholders to development and drive the implementation of large-scale complex provider network strategies for payers across the markets to include network development and expansion planning, network design, network performance optimization, provider initiatives, and provider data operational efficiencies. j. Lead and drive key department/division and interdepartmental/interdivisional projects and encourage effective use of process management tools and programs. k. Other duties as assigned.

This job requires a non-compete agreement.