Job Description
About the position :
This role is a high-level individual contributor responsible for supporting network contracting and network management programs across all lines of business. You will effectively collaborate with division leadership, program management, technology, vendor partners and business functions to drive and achieve Network Contracting objectives and key results. You will develop and provide ongoing monitoring of provider network requirements including NCQA, Qualified Health Plans (QHP) and Medicare Advantage (MA) network filings, network contracting, network management program support, and provider network initiative execution. You will ensure the department maintains all requirements in accordance with new and existing Federal and State regulations, BCBSA and Wellmark guidelines. You will support internal education, coordinate and manage cross-functional workgroups, and function as a key guest star for the [Agile] Product Team.
This position will work a hybrid schedule of at least 3 days (Tuesday, Wednesday, Thursday) in Wellmark's Des Moines office, with 2 days (Monday, Friday) remote option.
Qualifications
Required Qualifications :
Additional Information
What you will do as a Network Program Manager :
a. High level individual contributor who will function as the Network Contracting subject matter expert for NCQA, Mental Health parity (MHPHEA), network adequacy, government programs network filings, and Consolidated Appropriations Act (CAA).
b. Coordinate execution of Network Contracting program initiatives, projects and strategies that support business objectives through coordination with Health Network and Government Programs leadership, Network Contract Managers and additional stakeholders, serving as a subject matter expert or guest star for strategic workgroups or within Wellmark's Agile Product model.
c. Provide subject matter expertise in Medicare Advantage, Qualified Health Plan, and NQTL regulatory requirements.
d. Develop and prepare materials for conducting internal and external meetings with partners and vendors and strategic initiatives and presentations across the organization.
e. Establish and maintain strong relationships with internal stakeholders and vendor partners to champion the successful performance across all of Wellmark's Provider Networks.
f. Ensure that assigned Network Contracting initiatives are well designed, coordinated, and activities are executed timely and effectively to achieve completion of milestones.
g. Serve as lead and subject matter expert for Network Contracting for the Blue Cross Blue Shield Association and Blue Distinction Center programs.
h. Other duties as assigned.
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.
Applicants requiring a reasonable accommodation due to a disability at any stage of the employment application process should contact us at careers@wellmark.com
Please inform us if you meet the definition of a " Covered DoD official ".
At this time, Wellmark is not considering applicants for this position that require any type of immigration sponsorship (additional work authorization or permanent work authorization) now or in the future to work in the United States. This includes, but IS NOT LIMITED TO : F1-OPT, F1-CPT, H-1B, TN, L-1, J-1, etc. For additional information around work authorization needs please refer to the following resources : Nonimmigrant Workers and Green Card for Employment-Based Immigrants
Program Manager • Des Moines, Iowa, United States