Director, Network Development and Provider Solutions

Madison, WI, United States

Director, Network Development and Provider Solutions 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.

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 o pportunity 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

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 )

The base pay offered for this position may vary within the posted range based on your job-related knowledge, skills, and experience.

Work Location

We are a remote-first organization and offer remote work in the following approved states:

**This position will require some travel to onsite events across Wisconsin so the employee will be required to live in Wisconsin, a surrounding state of Wisconsin, or be willing to relocate to this area**

Remote and hybrid work options available

Performance bonus and/or merit increase opportunities

401(k) with dollar-per-dollar match up to 6% of salary (100% vested immediately)

Competitive paid time off

Health insurance, dental insurance, and telehealth services start DAY 1

Employee Resource Groups

Professional and Leadership Development Programs

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)

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