Full-time jobs in Des Moines, IA

About the role

Also known internally as a Sr Network Economics Analyst, you will lead, design, implement and maintain provider reimbursement strategies, including financial reporting for all Wellmark-contracted providers as well as multi-year agreements. This includes leading provider reimbursement initiatives by applying your thorough understanding of contracting, claims payment procedures and payment policy. Collaboration is key, so building and maintaining strong business relationships with other Health Network team members at Wellmark will be important to enhance the support we deliver to our providers. As a Senior-level team member, you will mentor team members and serve as the subject matter expert on the team, as well as be responsible for making recommendations to leadership on strategic and payment policy decisions.

What you'll bring

• You are a critical and strategic thinker, detail-oriented and analytical to your core.
• You enjoy using your advanced data analysis experience and consultative nature to make recommendations and partner with internal business leaders.
• Internal Job Title: Sr Network Economics Analyst
• Bachelor's degree in accounting, finance, business, economics or related field or direct and applicable work experience.
• Solid knowledge of and demonstrated ability in Microsoft Excel along with technical proficiency with tools such as Power BI, Tableau, SAS EG and/or SQL.
• Knowledge of hospital, physician and other provider payment and contracting strategies.
• Experience interpreting claims data, trends and provider utilization in order to determine payment strategy or payment strategy results.
• Demonstrated forethought of issues before questioned
• ability to research, ask questions and find solutions to potential problems.
• Demonstrated problem-solving, quantitative and analytical skills
• ability to recognize inconsistencies, analyze for reasonableness and accuracy, research and come to conclusions.
• Comprehensive knowledge of nationally recognized provider compensation strategies.

Benefits