Job Description

Wellmark is partnering with Korn Ferry on this search. To learn more or to be considered, contact Andrew Ulrich: andrew.ulrich@kornferry.com ****

About the opportunity: Wellmark’s Vice President (VP) of Provider Relations & Engagement is a senior business leader responsible for establishing and cultivating high-value relationships aimed at ensuring strategic alignment and impact with key stakeholders within our provider network. The development of these relationships is informed directly by network intelligence, a deep understanding of our strategy and the impact of this strategy on key stakeholders within this network. This VP will effectively engage with Wellmark’s provider network to build good-will and leverage exceptional business acumen to curate the long-term dialogue to deliberately socialize our strategy and tactics with unique audiences in mind.

As a senior leader and representative of Wellmark, this role will educate, inform, and partner face-to-face with key stakeholders to ensure the successful translation of financial implications and strategic alignment, building necessary awareness and buy-in to establish themselves as a trusted and valued partner.

Deeply collaborative in a highly matrixed environment, this role develops and employs a strategic listening to collect and synthesize intel and leverage this knowledge of our network to engage and provide valuable insights enterprise wide, to influence provider relationships. This role will lead a team accountable for creating customer value and competitive advantage through enhanced provider engagement which, when coupled with enhanced medical/benefit management techniques, improves health outcomes, and provides affordable and accessible health care products and services to customers throughout Iowa and South Dakota.

Because this VP is leader of leaders, this individual will directly impact the success, growth, and development of team members by setting clear strategy and expectations, defining accountabilities, providing regular coaching, facilitating change, and providing an overall positive work environment. Being a role model in behaviors that demonstrate Wellmark’s core competencies and Leader Success Expectations is a must.

Qualifications

Required Qualifications:

• Bachelor's degree in healthcare, business, or other related area, and/or direct and applicable work experience.
• Minimum of 7–10+ years of health insurance, managed care, State or Federal health program, or related industry experience that includes demonstrated relationship management skills with the proven ability to develop positive, long-term relationships with hospital, physician, and other healthcare leadership and/or personnel that promote positive and influential provider relations, effective negotiation, and marketing capabilities.
• Subject matter expertise in network development, contracting, risk sharing, and the development and implementation of innovative value-based contracting and alternative payment models.
• Understanding of and experience working with regulators at the state and federal levels (CMS, CMMI etc.) preferred.
• Demonstrates knowledge concerning how organizations function and can get things done through formal and informal channels and networks.
• Demonstrated leadership experience, leading leaders, partnering in a matrix environment, and developing high performing collaborative teams.
• Strong analytical, critical thinking, problem solving and research skills; uses data to inform decisions. Creative approach to continuous improvement and optimization.
• Strong consulting skills. Balances expertise and business acumen with understanding of customer/stakeholder needs.
• Develops collaborative relationships with executives, divisional leadership and operational teams resulting in the consistent development and delivery of strategic business planning solutions. Effectively influences others and resolves conflict.
• Exceptional written and verbal communication skills. Effectively articulates business implications and actionable recommendations to varying audiences, including executives. Strong presentation skills.
• Strong organizational skills and attention to detail. Skilled at moving from strategy into tactics. Establishes clear goals/expectations, aligns resources, and motivates teams in order to achieve success.
• Proactive and adaptable with strong change management skills. Effectively coaches and leads teams through change.
• Travel - 15%-20%+ of the time, including some overnight stays. Valid driver's license required.

Preferred Qualifications:

• Advanced degree in healthcare or business (MBA, MPH, MHA, etc.) strongly preferred.
• Previous experience within the provider network or health system and the ability to bring forward ideas and drive strategies to support the network; partner and think broadly across all networks and providers to drive provider alignment and enhancements.
• Knowledge of contracting and payment strategies, medical policy, benefit designs and product offerings.
• Prior experience working in both commercial and government program sectors is preferred.

Additional Information

What you will do as VP Provider Relations & Engagement:

• Provide the strategic direction and leadership for the provider relations & engagement team, focused on cultivating high-value provider relationships that align with corporate and divisional strategies and objectives. Oversee long term goals and measures that are consistent with these strategies and objectives.
• Implement strategies to support Wellmark’s relationships with providers to influence providers to act and produce measurable outcomes relative to improving quality, efficiency of care, and administrative performance.
• Provider Relationship Management: Develop strong, collaborative business relationships and establish face-to-face interactions with providers, strategic healthcare organizations, physicians, hospitals, health systems, provider and/or hospital organizations, medical societies, hospital associations, and healthcare organization leaders in Iowa and South Dakota to collect and synthesize network intel across Wellmark internal teams.
• Assist with and collaborate on progress towards the development and implementation of appropriate payment models with the provider community. Actively engage with provider network to build good-will and leverage exceptional business acumen to curate long-term dialogues aimed at deliberately socializing and gaining alignment with Wellmark direction.
• Through effective internal cross-collaboration, ensure fully integrated planning and strategies to produce measurable outcomes and drive innovative solutions to make health care more affordable for everyone, inclusive of medical policy, medical management, reporting, and the rising pressure from pharmacy costs. Understand and apply national, regional, and state/local trends that drive total cost of care to positively influence members/customers.
• Provide day-to-day leadership of financial and human resources, primarily focusing on employee and leader coaching, development, performance improvement, coordination and budgeting for multiple staff, and department(s) specific functions/services. Lead team to build their influence across the organization.
• Provide oversight of activities that support positive physician/hospital relationships with a focus on a data driven, collaborative approach. Collaborate with network providers to identify and execute on mutually beneficial initiatives that produce measurable outcomes on key administrative performance metrics.
• Develop relationships and represent Wellmark on both a state and national level in order to influence policy development and information sharing. Ensure activities conducted within the Provider Relations Department are in compliance with NCQA guidelines, the Public Exchange or other accrediting standards, compliance, department policy, and/or state and federal law.
• Build and maintain trusted relationships with Wellmark stakeholders.

This job requires a non-compete agreement.

An Equal Opportunity Employer

The policy of Wellmark Blue Cross Blue Shield is to recruit, hire, train and promote individuals in all job classifications without regard to race, color, religion, sex, national origin, age, veteran status, disability, sexual orientation, gender identity or any other characteristic protected by law.

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