Provider Contracts and Regional Development Manager
Group Health Cooperative of South Central Wisconsin
April 17, 2018
Full Time - Experienced
4 Year Degree
Group Health Cooperative of South Central Wisconsin (GHC-SCW), Madison, WI, is currently seeking a Provider Contracts and Regional Development Manager to provide leadership and direction with all contracted providers including the coordination and management of communication and problem resolution between provider groups, contracted hospitals, and patients. Additionally, this position serves in a leadership role for developing additional partnerships in strategic and high priority markets, advising leadership regarding issues and trends, and representing GHC-SCW in negotiations with other health networks.
Our Mission Statement: To provide accessible, comprehensive, high quality healthcare and outstanding service in an efficient and personalized manner to persons in the GHC-SCW service area.
Our Vision: To be a leader among HMO’s in providing high-quality medical care, impeccable service and competitive benefit levels and premium rates.
Our Common Values: • Patient Centered: When health insurers and health care providers are brought together under one roof, we are better together. Our care team model focuses on supporting the needs of our patients/members and providing the best in safe, high quality coordinated health care. Members and their providers participate in making meaningful decisions that lead to better outcomes. • Quality Driven: When members and their providers each participate meaningfully in the decisions that lead to better health care, we are better together. GHC-SCW continues its tradition of providing proactive health promotion and disease management outreach to our members to consistently achieve high quality health care accreditation. • Innovation: When we work to lift each other up, show appreciation and collaborate in the best interests of the member, we are better together. GHC-SCW has made innovative advancements which include the implementation of an electronic medical records system (EMR) and GHC-SCW MyChartSM, access to innovative Complementary Medicine benefits and Wellness reimbursement services. • Community Involved: When we join with our community to further the causes for which we share a common concern, we are better together. We are proud to promote programs that strengthen lives, and make our community a safer, stronger and healthier place to live and grow. GHC-SCW employees share their time and talent; and we recognize that the value of what we give is also what we gain – for our employees, our members and our community. • Not for Profit Cooperative: When we share a common purpose, a common voice and a common vision, we are better together. We use our surpluses to improve clinics, enhance health care benefits and give back to the community. Our members, not our profits, are our priority. We have a unique “cooperative” governance structure which works directly for our members.
GHC-SCW is committed to fostering a caring and compassionate environment while ensuring that individual differences are valued. GHC-SCW is a quality driven cooperative built on collaboration, community involvement, innovation, and belonging. It is essential that all employees, members, and patients feel secure and welcome, that the opinions and contributions of all individuals are respected and that all voices are heard.
We believe: Healthcare is a human right. In treating all people with dignity and respect. There is strength in diversity. Equity celebrates our humanity. We are better together.
JOB SPECIFIC MINIMUM QUALIFICATIONS 1. Bachelor’s degree from an accredited college or university in Business, Healthcare Administration, Public Relations/Communications or relevant field required. 2. Minimum of five (5) to seven (7) years experience directly related to contract negotiations and administration, and communications and relations with a variety of healthcare groups required. Experience related to Sales and/or Marketing is desirable 3. Knowledge of local and regional healthcare community including medical insurance, provider organizations and healthcare facilities. 4. Knowledge and ability to understand issues related to the delivery of medical services to regional communities. 5. Ability to develop and sustain relationship with a variety of healthcare providers and organizations. 6. Knowledge of local and national issues and trends in managed care and primary health care required. 7. Extensive knowledge of HMO / healthcare related contracting and ability to negotiate contracts and develop and analyze proposals. 8. Strong interpersonal and communications skills and the ability to work effectively with a wide range of constituencies in a diverse community required. Ability to be culturally sensitive and to work with diverse populations. 9. Ability to analyze and solve problems including resolution of customer complaints and concerns required. Excellent conflict resolution abilities. 10. Knowledge of laws, regulations, and documentation requirements for the management of an employee health plan required. 11. Knowledge of the administrative procedures and data requirements of employee health plans required. Ability to use computer software systems and programs including contract management, spreadsheet, database/reporting programs; word processing, email and scheduling software.
Group Health Cooperative of South Central Wisconsin is proud to be an equal opportunity employer. GHC-SCW considers candidates regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.
About Group Health Cooperative of South Central Wisconsin
Group Health Cooperative of South Central Wisconsin (GHC-SCW) is a not-for-profit managed health care organization that provides the entire spectrum of health care services, including insurance, Primary Care and Specialty Care. We have a rich and diverse 40 year history as a member-owned cooperative and are consistently ranked one of the top health plans in Wisconsin and in the nation.
GHC-SCW is proud to be an Equal Opportunity Employer.