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Description
Our Provider Contracting and Provider Relations Manager will have extensive familiarity with the Wisconsin provider landscape and have a passion for driving healthcare value. In this role, you will negotiate agreements with independent providers and health systems by establishing trust and maintaining mutually beneficial provider relationships. Will also work with our current provider networks, developing, and advancing provider relationships, modeling, and negotiating agreements to ensure WPS delivers the highest value, competitive, and innovative provider solutions in the Wisconsin market. Salary Range
$80,000 $110,000
The base pay offered for this position may vary within the posted range based on your job-related knowledge, skills, and experience.
Work Location
This role will occasionally work out of our Madison, WI headquarters and travel to providers in Wisconsin; first consideration will be individuals located in Wisconsin to take advantage of regional provider coverage. Our office location: WPS Corporate Center Building - 1717 W. Broadway in Madison, WI.As a Provider Contracting and Provider Relations Manager you will:
Manage relationships and serve as first point of contact for assigned providers.
Secure and renegotiate network agreements as needed to improve value or to comply with Federal and State regulatory changes.
Analyze and prepare contract proposals that achieve corporate goals for unit cost, utilization, quality metrics, and network adequacy.
Educate providers on policy changes, resources, and tools that impact their WPS provider experience.
Monitor contracts for unit cost, utilization, member satisfaction, quality performance, and network adequacy.
Work collaboratively with other areas to answer network and provider questions and improve processes.
Review and approve system configuration and network validation for certain agreements.
Work with the Director to identify and implement innovative contracting strategies.
Meet with providers as needed by phone, video or in person, and participate in community functions representing WPS.
Lead / support cross-functional projects that advance corporate initiatives.
Participate in workgroups and teams as requested.
How do I know this opportunity is right for me? If you:
Thrive in taking on challenges and enjoy an environment that is constantly evolving.
Have a strong desire to learn the ‘how’ and ‘why’ of healthcare reimbursement.
Communicate with confidence, clarity, and respect with all levels of staff and management.
Are a problem-solver – developing, evaluating, and implementing solutions.
Possess exceptional skillsets in relationship-building and contract negotiation.
Are a thought leader and know how to mentor, grow, and engage teams.
What will I gain from this role?
Expanding or showcasing your skills in contract negotiation and relationship development.
Gaining experience in the design and implementation of new contracting methodologies.
Playing an integral role in supporting key initiatives that contribute to organizational success.
Being a part of a dynamic team committed to maintaining a collaborative, innovative work culture.
Working with a leader that trusts, values, and encourages individuals to excel and fosters career growth.
Working in a continuous performance feedback environment.
Minimum Qualifications
Bachelor's Degree in related field or equivalent post high school and/or related work experience.
3 or more years of work experience specifically in contracting, provider relations, or network development.
Preferred Qualifications
5 or more years of directly related experience to include contracting for healthcare services within a health plan network or for a health care provider organization.
Experience working with a variety of healthcare reimbursement models for both professional and facility services.
Familiarly with the Wisconsin provider landscape.
Strong experience using MS Excel and other Microsoft Office applications.
Remote Work Requirements
High speed cable or fiber internet
Minimum of 10 Mbps downstream and at least 1 Mbps upstream internet connection (can be checked at https://speedtest.net)
Please review Remote Worker FAQs (https://secure.wpsic.com/files/remote-work-faqs.pdf) for additional information
Benefits
Remote and hybrid work options available
Performance bonus and/or merit increase opportunities
401(k) with a 100% match for the first 3% of your salary and a 50% match for the next 2% of your salary (100% vested immediately)
Competitive paid time off
Health insurance, dental insurance, and telehealth services start DAY 1
Professional and Leadership Development Programs
Review additional benefits: ( https://www.wpshealthsolutions.com/careers/fulltime_benefits.shtml )
Who We Are
WPS Health Solutions (https://www.wpshealthsolutions.com/about/index.shtml) is a leading not-for-profit health insurer and federal government contractor headquartered in Wisconsin. WPS offers health insurance plans for individuals, families, seniors, and group health plans for small to large businesses. We process claims and provide customer support for beneficiaries of the Medicare program and manage benefits for millions of active-duty and retired military personnel across the U.S. and abroad. WPS Health Solutions has been making health care easier for the people we serve for more than 75 years (https://www.wpshealthsolutions.com/75/) . Proud to be military and veteran ready.
Culture Drives Our Success
WPS’ Culture is where the great work and innovations of our people are seen, fueled, and rewarded. We accomplish this by creating an open and empowering employee experience. We recognize the benefits of employee engagement as an investment in our workforce—both current and future—to effectively seek, leverage, and include differing and unique perspectives that fuel agility and innovation on high-performing teams. This results in people bringing their authentic selves to work every day in an organization that successfully adapts to business changes and new opportunities.
We are proud of the recognition we have received from local and national organization regarding our culture and workplace: WPS Newsroom - Awards and Recognition. (https://www.wpshealthsolutions.com/news/?c=awards)
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Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)