at WPS Health Solutions in Marion, Illinois, United States
Job Description
Description
Who We Are
WPS Health Solutions 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. 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 inclusive and empowering employee experience. We recognize the benefits of Diversity, Equity, and Inclusion as an investment in our workforce-both current and future-to effectively seek, leverage, and include diverse 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
Role Snapshot
You will lead the WPS Network and contracting activities, providing oversight for advancing the current provider network, developing, and advancing provider relationships, modeling, and negotiating agreements, and managing vendor relationships to ensure WPS delivers the highest value, competitive, and innovative provider solutions in the Wisconsin market.
Developing provider network and contracting strategies to ensure members and customers have access to high value health care.
Analyzing, modeling, presenting, and negotiating provider contracts including mentoring a team to improve unit cost, utilization, and quality metrics.
Providing ongoing management and oversight of third-party networks, vendors, and provider contracts for unit cost, utilization, member satisfaction, and quality performance
Establishing and managing relationships with key providers, third-party networks, and vendors.
Resolving inefficient or problematic issues and processes that hinder WPS and providers operations.
Representing WPS in WI provider community, attend external meetings, including finalist presentations to employer groups, community or provider activities, or other related functions.
Ensuring compliance with all regulatory requirements related to provider networks
How do I know this opportunity is right for me? If you:
You love working with providers to ensure individuals have access to high quality health care
You thrive in a fast-paced team-based environment
You enjoy building, advancing, and transforming processes and procedures
You are a passionate leader who develops strong teams that are known for delivering results
You embrace opportunities to build and innovate, you like to think outside the box
You are solution driven and dive in, you don't wait to be told what to do
What will I gain from this role?
An opportunity to:
work with a likeminded but diverse team who are passionate about improving health care for those we serve
further develop a team; advancing performance and results
build strong relationships in the Wisconsin provider community
work in a continuous performance feedback environment
Minimum Qualifications
Must live in or around the Wisconsin area
Bachelor's Degree in related field or equivalent post high school and/or related work experience
5 years of direct related work and leadership experience
Preferred Qualifications
5 years leading provider and network contracting efforts, analyzing data, establishing contracting goals, building relationships and partnerships with providers
5 years working at a Commercial Health Plan (can be concurrent)
Preference will be given to candidates who have knowledge of or existing relationships with providers in the Wisconsin market.
Proven experience leading high performing teams
Strong experience using MS Suite including Excel
Remote Work Requirements
Wired (ethernet cable) internet connection from your router to your computer (add this bullet point only IF your role requires a wired connection)
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 for additional information
Salary Range
$150,000-$200,000 annually
The base pay offered for this position may vary within the posted range based on your job-related knowledge, skills, and... For full info follow application link.
Wisconsin Physicians Service Insurance Corporation is an Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities employer.
