Wellmark, Inc.
healthcare
ProviderNetworkStrategy&ContractingConsultant
“Provider Network Strategy & Contracting Consultant at Wellmark, Inc.. Skills: Provider network strategy, Provider network contracting, Value-based negotiations, Contract drafting, Provider performance, Analysis, Negotiation, Influence, Relationship management. Advance complex provider network agreements. High-level, fee for service and value‑based negotiations”
What You'll Achieve.
Advance complex provider network agreements that support the organization’s broader business strategy; Support business goals; Drive process improvements; Strategic alignment; Positive business outcomes; Ensure agreements align with Wellmark’s quality, financial, and regulatory standards; Support long‑term network sustainability; Ensure consistency with network strategy, payment methodology, and provider readiness; Develop recommendations for network expansion, optimization, or contractual modifications; Ensure accuracy, consistency, and compliance; Develop innovative, data‑driven solutions; Support strategic execution and operational consistency; Ensure alignment with contracting, network payment strategy and enterprise objectives
Industry & Context.
Operational problem‑solving and troubleshooting capabilities; Intellectual aptitude to understand healthcare industry dynamics, evaluate complex issues, and develop practical, sustainable solutions; Highly developed critical‑thinking skills; Creatively apply data and insights to drive process improvements, strategic alignment, and positive business outcomes; Assess alternatives; Develop innovative, data‑driven solutions
Non-compete agreement, Approximately 10% travel
What They're Looking For.
Must Have
Bachelor's degree or direct and applicable work experience, 5+ years of progressive experience in provider network contracting, demonstrating 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, 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
Nice 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, Proficiency in HROR highly preferred
What You'll Do.
Advance complex provider network agreements
fee for service and value‑based negotiations
Significant contract drafting
Translate business needs into well‑structured
executable agreements
Drive work forward on multi‑year agreements
Prepare executive‑level materials
Ensure momentum from strategy through execution
Align contract terms with performance objectives
and total cost of care strategy
Evaluate network performance
Design provider-specific contracting and methodology strategies
Support the governance and continuous improvement of contracting policies
and program documentation
Execute complex fee‑for‑service and value‑based provider contract negotiations
Ensure agreements align with quality
and regulatory standards
Support long‑term network sustainability
Lead the operational implementation of new and evolving value‑based payment models
Ensure consistency with network strategy
and provider readiness
Serve as a subject matter expert for escalated provider contract and network status issues
Provide expert guidance and resolution support to internal stakeholders
Assess provider network composition and adequacy
Develop recommendations for network expansion
or contractual modifications
and maintenance of provider contracts and amendments
and compliance of contracts
Evaluate complex issues
and develop innovative
data‑driven solutions
Manage multiple complex initiatives concurrently
Build and sustain effective provider relationships
Lead department‑level and cross‑functional initiatives
Act as a primary liaison with healthcare organizations on value‑based contracting matters
How You'll Work.
Team & Collaboration
Work in close partnership with Legal to translate business needs into well‑structured, executable agreements; Collaborate closely with Network Contracting, Network Performance, and Network Payment Strategy teams; Partner closely with internal teams to resolve high-level issues; Collaborate across matrixed teams; Partners effectively with different business areas; Driving results through collaboration and effective partnership with diverse business areas; Collaborates with internal partners to assess provider network composition and adequacy; Partners closely with Network Contracting, Network Payment Strategy, and Legal to support the drafting, execution, and maintenance of provider contracts and amendments; Develop innovative, data‑driven solutions in collaboration with internal teams and external partners; Ensuring clarity, alignment, and coordination across stakeholders; Support strategic execution and operational consistency
Communication Scope
Excellent written and verbal communication skills; Ability to clearly convey complex information, recommendations, and contracting considerations to a variety of audiences, including providers and internal stakeholders, adapting messaging as appropriate
Process & Methodology
Managing complex provider agreements, Managing multiple complex initiatives concurrently, Organizational skills, Prioritization skills, Execution skills, Established business and process‑management tools
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