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Job Details

Provider Contracting and Strategy Director

Company name
Wisconsin Physicians Service Insurance Corporation

Location
Madison, WI, United States

Employment Type
Full-Time

Industry
Planning, Manager, Finance

Posted on
Apr 10,2019

Valid Through
Jul 24,2019

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Profile

Corp Center Building,Address:{Line1:null,Line2:null,City:Madison,State:{Name:Wisconsin,Code:WI},PostalCode:null,Country:{Id:714949bd-a724-4524-a144-e4288d5eb2de,Name:United States,Code:USA}},DisplayName:false,DisplayLocationId:false,DisplayDescription:false,DisplayAddress:true,DisplayStreetAddress:false,Coordinates:{Longitude:-89.386689641632941,Latitude:43.07295123857206},Shapes:null,SourceOfTruth:1,IsAvailableForOpportunities:true},{Id:69ff4b59-36f4-570f-a9d0-76a9c84ac2c3,LocalizedName:Eau Claire,WI,LocalizedLocationId:null,LocalizedDescription:Eau Claire Building,Address:{Line1:null,Line2:null,City:Altoona,State:{Name:Wisconsin,Code:WI},PostalCode:null,Country:{Id:714949bd-a724-4524-a144-e4288d5eb2de,Name:United States,Code:USA}},DisplayName:false,DisplayLocationId:false,DisplayDescription:false,DisplayAddress:true,DisplayStreetAddress:false,Coordinates:{Longitude:-91.435097540219445,Latitude:44.806871616973062},Shapes:null,SourceOfTruth:1,IsAvailableForOpportunities:true},{Id:6e01b13d-a269-5310-b0c9-65844f573f19,LocalizedName:null,LocalizedLocationId:null,LocalizedDescription:Green Bay, WI,Address:{Line1:null,Line2:null,City:null,State:{Name:Wisconsin,Code:WI},PostalCode:null,Country:{Id:714949bd-a724-4524-a144-e4288d5eb2de,Name:United States,Code:USA}},DisplayName:false,DisplayLocationId:false,DisplayDescription:true,DisplayAddress:false,DisplayStreetAddress:false,Coordinates:{Longitude:-89.929719549329945,Latitude:43.237114799979061},Shapes:null,SourceOfTruth:1,IsAvailableForOpportunities:true},{Id:76922e5e-3ee6-532d-a5ec-3e4fb841925d,LocalizedName:null,LocalizedLocationId:null,LocalizedDescription:Milwaukee, WI,Address:{Line1:null,Line2:null,City:null,State:{Name:Wisconsin,Code:WI},PostalCode:null,Country:{Id:714949bd-a724-4524-a144-e4288d5eb2de,Name:United States,Code:USA}},DisplayName:false,DisplayLocationId:false,DisplayDescription:true,DisplayAddress:false,DisplayStreetAddress:false,Coordinates:{Longitude:-89.929719549329945,Latitude:43.237114799979061},Shapes:null,SourceOfTruth:1,IsAvailableForOpportunities:true}],PostedDate:2019-04-10T14:35:52.417Z,UpdatedDate:2019-04-12T13:25:53.047Z,RequisitionNumber:PROVI03749,Description:\u003cp\u003e\u003cstrong\u003eWho We Are\u003c/strong\u003e\u003c/p\u003e
\u003cp\u003eWe are a leading not-for-profit health insurer in Wisconsin, and our services have grown to reach active-duty and retired military personnel, seniors, and families in Wisconsin, across the U.S., and around the world.\u0026nbsp;\u003ca href=\u0022http://www.wpshealthsolutions.com/about/index.shtml\u0022 target=\u0022_blank\u0022 rel=\u0022noopener\u0022\u003eLearn more!\u003c/a\u003e\u003c/p\u003e
\u003cp\u003eWPS receives World\u0027s Most Ethical Company Award for 10th Year in a Row\u003cstrong\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e-\u0026nbsp;\u003c/strong\u003e\u003ca href=\u0022http://wpshealthsolutions.com/news/news-worlds-most-ethical-companies-2019-02262019.shtml\u0022 target=\u0022_blank\u0022 rel=\u0022noopener\u0022\u003e\u003cstrong\u003e2019 Most Ethical Companies Announcement\u003c/strong\u003e\u003c/a\u003e\u003c/p\u003e
\u003cp\u003e\u003cstrong\u003eAt Our Core\u003c/strong\u003e\u003c/p\u003e
\u003cp\u003eWPS Health Solutions has earned a reputation as a leader in the insurance and benefits administration industry through our commitment to excellence and high-quality service. Our corporate values reflect the core of who we are and how we conduct business every day.\u003c/p\u003e
\u003ctable width=\u0022672\u0022\u003e
\u003ctbody\u003e
\u003ctr\u003e
\u003ctd\u003e
\u003cp\u003e\u003cstrong\u003eCustomer Focused\u003c/strong\u003e\u003c/p\u003e
\u003cp\u003e\u003cstrong\u003eI recognize how my actions impact internal and external customers\u003c/strong\u003e\u0026nbsp;by being responsible for the customer experience. I look beyond the immediate issue to recognize and solve the problem.\u003c/p\u003e
\u003c/td\u003e
\u003ctd\u003e
\u003cp\u003e\u003cstrong\u003eIndividual Responsibility\u003c/strong\u003e\u003c/p\u003e
\u003cp\u003e\u003cstrong\u003eI own my actions.\u003c/strong\u003e\u0026nbsp;I am accountable and dedicated to achieving the best results for WPS Health Solutions and our customers. I embrace my role in helping the company achieve a high-performance workplace.\u003c/p\u003e
\u003c/td\u003e
\u003c/tr\u003e
\u003ctr\u003e
\u003ctd\u003e
\u003cp\u003e\u003cstrong\u003eMutual Respect\u003c/strong\u003e\u003c/p\u003e
\u003cp\u003e\u003cstrong\u003eI lead by example and act ethically, honestly and am trustworthy.\u003c/strong\u003e\u0026nbsp;I show appreciation for others by giving and taking constructive feedback and encouragement.\u0026nbsp;\u003c/p\u003e
\u003c/td\u003e
\u003ctd\u003e
\u003cp\u003e\u003cstrong\u003eDriven and Passionate\u003c/strong\u003e\u003c/p\u003e
\u003cp\u003e\u003cstrong\u003eI approach my work with enthusiasm, and personal commitment to the success of our business.\u003c/strong\u003e\u0026nbsp;I keep the importance of the work we do for our customers alive in my attitude and interactions with others, and demonstrate pride in the worthiness of our purpose.\u003c/p\u003e
\u003c/td\u003e
\u003c/tr\u003e
\u003c/tbody\u003e
\u003c/table\u003e
\u003cp\u003e\u003cstrong\u003ePosition Summary\u003c/strong\u003e\u003c/p\u003e
\u003cp\u003eThe \u003cstrong\u003eProvider Contracting and Strategy Director \u003c/strong\u003ewill provide oversight for developing provider network strategies, creating and maintaining provider relationships, and modeling and negotiating agreements with independent providers, health systems, and third-party networks and vendors to ensure cost-effective insurance products with a strong focus on customers.\u003c/p\u003e
\u003cp\u003e\u003cstrong\u003eIn this role you will:\u003c/strong\u003e\u003c/p\u003e
\u003cul\u003e
\u003cli\u003eDevelop provider network and contracting strategies to achieve corporate goals, focusing on excellent customer service and cost-effective health insurance products.\u003c/li\u003e
\u003cli\u003eDevelop, analyze, model, present, and negotiate provider and third-party network and vendor contracts that achieve corporate goals for unit cost, utilization, and quality metrics.\u003c/li\u003e
\u003cli\u003ePropose, draft, review, present, and negotiate complex provider and third-party network and vendor contract language to benefit company, protect interests, and ensure company is not disadvantaged during course of a contract term.\u003c/li\u003e
\u003cli\u003eMonitor third-party network, vendor, and provider contracts for unit cost, utilization, member satisfaction, and quality performance.\u003c/li\u003e
\u003cli\u003eDevelop and manage relationships with providers and third-party networks and vendors.\u003c/li\u003e
\u003cli\u003eDevelop and manage product features with providers and third-party networks and vendors that enhance insurance offerings and customer experience.\u003c/li\u003e
\u003cli\u003eLead or represent Provider Relations Department on committees and work groups to develop networks and products for insurance offerings.\u003c/li\u003e
\u003cli\u003eDevelop and implement provider communication strategy to articulate company policies and procedures.\u003c/li\u003e
\u003cli\u003eResolve inefficient or problematic issues and processes that hinder WPS and providers operations.\u003c/li\u003e
\u003cli\u003eAttend on-site meetings to represent company and/or department, including finalist presentations to employer groups, provider fundraising, or open house functions.\u003c/li\u003e
\u003cli\u003eOversee Provider Directory and Find a Doc tools.\u003c/li\u003e
\u003cli\u003eParticipate in WPS Appeals.\u003c/li\u003e
\u003c/ul\u003e
\u003cp\u003e\u003cstrong\u003eYou should have:\u003c/strong\u003e\u003c/p\u003e
\u003cul\u003e
\u003cli\u003eBachelor\u0026rsquo;s degree in Business, Health Administration, Finance, or related field OR equivalent post high school education and/or experience\u003c/li\u003e
\u003cli\u003e7 or more\u0026nbsp;years of related work experience to include two (2) years in a supervisory capacity\u003c/li\u003e
\u003cli\u003eMust possess a valid driver\u0026rsquo;s license for occasional travel and overnight stays (up to 10% travel)\u003c/li\u003e
\u003c/ul\u003e
\u003cp\u003e\u003cstrong\u003eIn addition, we prefer:\u003c/strong\u003e\u003c/p\u003e
\u003cul\u003e
\u003cli\u003eInsurance and/or healthcare background\u003c/li\u003e
\u003cli\u003eMedicare Advantage contracting experience\u003c/li\u003e
\u003c/ul\u003e
\u003cp\u003e\u0026nbsp;\u003c/p\u003e
\u003cp\u003e\u003cstrong\u003eStay connected:\u0026nbsp;\u003c/strong\u003e\u003ca href=\u0022http://recruiting2.ultipro.com/WIS1003/JobBoard/e6da0c90-f987-63dc-99a9-fb8c9014f57e/Account/Register?cancelUrl=https://recruiting2.ultipro.com/WIS1003/JobBoard/e6da0c90-f987-63dc-99a9-fb8c9014f57e/?q=WPS&o=relevance\u0026amp;redirectUrl=/WIS1003/JobBoard/e6da0c90-f987-63dc-99a9-fb8c9014f57e/JobSearchAgent\u0022 target=\u0022_blank\u0022 rel=\u0022noopener\u0022\u003e\u003cstrong\u003eSign-up for Job Alerts\u003c/strong\u003e\u003c/a\u003e\u003c/p\u003e
\u003cp\u003e\u003cstrong\u003eFOLLOW US!\u003c/strong\u003e\u003c/p\u003e
\u003cp\u003e\u003ca href=\u0022https://www.facebook.com/WPSHealthSolutions/\u0022 target=\u0022_blank\u0022 rel=\u0022noopener\u0022\u003e\u003cstrong\u003eFacebook\u003c/strong\u003e\u003c/a\u003e\u003c/p\u003e
\u003cp\u003e\u003ca href=\u0022https://twitter.com/WPS_HS\u0022 target=\u0022_blank\u0022 rel=\u0022noopener\u0022\u003e\u003cstrong\u003eTwitter\u003c/strong\u003e\u003c/a\u003e\u003c/p\u003e
\u003cp\u003e\u003ca href=\u0022https://www.linkedin.com/company/wps-health-solutions/\u0022 target=\u0022_blank\u0022 rel=\u0022noopener\u0022\u003e\u003cstrong\u003eLinkedIn\u003c/strong\u003e\u003c/a\u003e\u003c/p\u003e,EqualOpportunityEmployerDescription:Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities,PayTransparencyPolicyStatement: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.,MatchScore:1.0,HasApplied:false,ApplicationJobBoardName:null,ApplicationJobBoardId:null,DateApplied:null,Salaried:true,CompensationAmount:null,PublishingStatus:1,Links:[],BehaviorCriteria:[],MotivationCriteria:[],EducationCriteria:[],LicenseAndCertificationCriteria:[],SkillCriteria:[],WorkExperienceCriteria:[],JobBoardMemberships:[{JobBoardId:cdefa8ae-f907-5c13-2775-f0106d0aa34a,PublishedInternal:true,PublishedExternal:false,ExternalPostedDate:null,InternalPostedDate:2019-04-12T13:26:10.724Z},{JobBoardId:e6da0c90-f987-63dc-99a9-fb8c9014f57e,PublishedInternal:false,PublishedExternal:true,ExternalPostedDate:2019-04-12T13:26:10.724Z,InternalPostedDate:null}],AssessmentUri:null,AssessmentStatus:null,OpportunityIsClosed:false,TravelRequired:null,TravelDescription:null,SupervisorName:null});

Company info

Wisconsin Physicians Service Insurance Corporation
Website : http://www.wpsic.com

Company Profile
Wisconsin residents can count on WPS Health Insurance to help protect their health, financial security, and peace of mind. WPS provides health insurance, life insurance, and benefit plan administration to private and government customers with service and value considered by our customers to be the very best. WPS is one of the largest health benefits providers in Wisconsin. From traditional preferred provider organization (PPO) plans and self-funded administration to consumer-driven options like our health savings account (HSA)-qualified high-deductible and health reimbursement account (HRA) plans, WPS offers a broad array of products to meet the needs of group and individual customers. In addition, more than 30,000 Wisconsin seniors choose us for supplemental insurance that helps fill the gaps left by Medicare, and more than 24,000 more have enrolled in our Medicare prescription drug plans.*

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