Provider Relations Manager

Wellmark, Inc.•Des Moines, IA

1d•Hybrid

About The Position

As a Provider Relations Manager on the Network Relations team, you will have accountability to develop and maintain strong, positive relationships with Wellmark’s in-network health care organizations. You will be responsible for facilitating strategic initiatives that support improved quality, efficiency of care, and administrative performance by providers. You will serve as a subject matter expert and a partner to other internal departments as well. You will act as a liaison between Wellmark and providers to strategically bring new initiatives and programs to fruition. Success in this position will be measured by the ability to engage key health care organizations in programs that may be pilots or more conceptual in nature.

Requirements

Bachelor's degree or direct and applicable work experience.
4+ years of experience: in health insurance, health care, or related industry experience as well as in roles focused on relationship management (e.g. physician, hospital), strategic consultation, and analysis of data/information.
Ability to build and maintain relationships with colleagues and external stakeholders.
Effective consultation skills, including the ability to persuade and influence key decision makers.
Demonstrated ability to communicate effectively verbally and in writing, expressing complex concepts clearly and concisely with multiple levels of an organization, including external stakeholders and professional organizations. Ability to develop and facilitate presentation as needed.
Ability to apply strong analytical, problem solving, and critical and strategic thinking to work with vendors and internal departments. Willingness to take an innovative, creative approach to solving problems and developing solutions.
Self-starter motivated by the opportunity to work in fast-paced environments and driven by measurable outcomes. Ability to operate independently yet cooperatively on teams to appropriately manage priorities while maintaining positive relations.
Strong organization, time management, and prioritization skills. Ability to manage multiple projects while adjusting to changing priorities and business needs.
Ability to develop and maintain documentation of processes and procedures and make decisions by following established guidelines.
Proficiency with Microsoft Office applications, such as Word, Excel, Outlook, PowerPoint or Access.
Travel required between 20-30%. Valid Driver’s license.

Responsibilities

Build and maintain positive physician/hospital relationships with a focus on a collaborative approach to quality care, network development and stability, cost containment, administrative simplification, and the identification and resolution of barriers to success.
Accountable for relationship management with providers in assigned territories and/or specific health care organizations, which includes effectively partnering with a multi- disciplinary internal team of subject matter experts and external vendors to provide excellent operational service and support.
Influence key health care organizations to engage in strategic Wellmark initiatives and produce measurable outcomes relative to improving quality, efficiency of care, and key administrative metrics.
Work with providers on multiple projects/pilots at a time with competing deadlines. Clearly communicate expectations and objectives of each initiative/project. Assist provider organizations as necessary in the development of project plans, and implementation and on-going support of program/pilot initiatives (including measuring and monitoring results, status reporting, and project plan completion) to ensure alignment with divisional goals.
Serve as liaison to health care organizations regarding contracting issues and ensure consistency with compensation strategy. Partner with appropriate subject matter experts to share health care organization’s concerns and comments. Coordinate communication effort to share a clear and concise Teachable Point of View with health care organizations.
In collaboration with internal partners, perform qualitative and quantitative analysis on complex business problems using a variety of data, (i.e., claims, quality) to identify mutually beneficial initiatives to Wellmark and providers that produce measurable outcomes on key administrative performance metrics.
Develop and deliver health care organization specific and/or public presentations to educate network providers about strategic initiatives. Authors reports and prepares presentations to be shared internally and externally as requested.
Demonstrate knowledge and support of corporate initiatives related to health care organizations engagement, quality and efficiency of care, and prioritize work activities to support them.
Develop proactive and positive cross-functional working relationships with other Wellmark divisions/departments to resolve health care organizations issues.
Other duties as assigned.