Provider Contract Manager
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AI Summary
Our Provider Contract Manager oversees the full lifecycle of provider and vendor agreements to support the delivery of high-quality healthcare services to plan members. They are responsible for negotiating competitive contract terms, drafting and maintaining agreements, and ensuring compliance with organizational and regulatory standards. This Provider Contract Manager requires building and sustaining strong, collaborative relationships with independent providers, health systems, third-party networks, and vendor partners. Key responsibilities include negotiating reimbursement rates, managing contract renewals, resolving disputes, and optimizing contract performance to align with business objectives and network strategy.
Salary Range
$85,000~$110,000
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 open to remote work in the following approved states:
Illinois, Iowa, Minnesota, Wisconsin
Employees living within 45 miles of WPS Headquarters (1717 W. Broadway in Madison, WI) will be expected to be able to come into the office 2 days a week on a regular basis.
In this role you will:
- Serve as the primary relationship manager for assigned providers, ensuring strong communication, engagement, and satisfaction.
- Negotiate and execute provider contracts, including rates, reimbursement methodologies, and contract terms, in compliance with regulatory requirements.
- Analyze contract performance and provider data to ensure alignment with organizational goals related to cost, quality, utilization, and member satisfaction.
- Educate providers on policies, tools, and resources to enhance collaboration and improve overall provider experience.
- Collaborate cross-functionally to resolve provider issues, support network operations, and drive process improvements.
- Support strategic initiatives and contracting innovations while ensuring accurate system configuration and network validation for agreements.
Minimum Qualifications
- Bachelor’s degree in a related field, or equivalent combination of education and relevant work experience.
- 5 or more years of experience in contracting, provider relations, or network development
- Proven experience in contract negotiations.
- Strong critical thinking and analytical skills.
- Excellent communication skills with the ability to influence and build relationships across various stakeholders.
Preferred Qualifications
- Experience in contracting for healthcare services within a health plan network or for a health care provider organization.
- Experience working with a variety of healthcare reimbursement models for professional, facility and ancillary services.
- Familiarity with the Wisconsin provider landscape.
- Strong experience using MS Excel and other Microsoft Office applications.
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)
- Please review Remote Worker FAQs for additional information
Benefits
- Remote and hybrid work options available
- Performance bonus and/or merit increase opportunities
- 401(k) with a 100% match for the first 3% of your salary and a 50% match for the next 2% of your salary (100% vested immediately)
- Competitive paid time off
- Health insurance, dental insurance, and telehealth services start DAY 1
- Professional and Leadership Development Programs
- Review additional benefits: (https://www.wpshealthsolutions.com/careers/)
Who We Are
WPS, a health solutions company, is a leading not-for-profit health insurer and federal government contractor headquartered in Madison, 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 has been making healthcare easier for the people we serve for nearly 80 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 open and empowering employee experience. We recognize the benefits of employee engagement as an investment in our workforce—both current and future—to effectively seek, leverage, and include differing and unique 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.
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