Provider Specialist – Wisconsin (Hybrid)

Job Type

Full-time

Description

Culture Highlights!

  • Telework environment – work from where it’s most convenient, home, office, etc.
  • Flexible work model – flex your time to blend work and life to fit various lifestyles/needs.
  • Monday through Friday schedule.
  • 9 paid holidays, and 3 additional floating holidays (pro-rate applies).
  • Volunteer in your community – 24 hours awarded annually.
  • Professional Growth – internal and external learning and development opportunities.
  • Robust Total Rewards – Medical/Dental/Vision, Telehealth, Flex Spending, 401k Matching, Life insurance, LT/ST Disability, EAP, & Mileage Reimbursement.
  • Eligible employer for Federal Public Service Loan Forgiveness Program.

**Hiring anywhere within Wisconsin only, most ideal within our service regions. Travel onsite or in-person will be required as needed.**

Position Summary:

The Provider Specialist develops and maintains a network of high quality and culturally competent service providers to meet members’ needs, negotiates rates for service provider contracts, monitors provider quality and contract compliance, and builds positive working relationships with service providers, community representatives, county departments, Interdisciplinary Team (IDT) staff, and others to develop and maintain contracts and community resources necessary to meet the needs of Lakeland Care Inc’s (LCI’s) population. 

Responsibilities & Competencies:

  • Recruit new providers and promote expansion within the current provider network.
  • Negotiate rates and creatively solve problems with providers to ensure a cost-effective, robust, and high-quality network of providers.
  • Offer education and orientation to providers, hospital discharge planners and others including an overview of Lakeland Care and the Family Care program. Following contract completion, support new providers through regularly scheduled follow up.
  • Establishes and maintains positive working relationships with service providers. Collaborates and meets with providers and LCI staff to understand service delivery and monitor quality. 
  • In collaboration with the Provider Relations & Contracting Team, participate in External Quality Review (EQR) and Certification processes; assist with the quality improvement/quality assurance plan.
  • Attend and assist in the coordination of provider forums and other activities to educate providers on agency procedures, service delivery, and contract standards.  
  • Facilitate service development for members relocating from institutional settings into the community using the Request for Proposal (RFP) process, when deemed appropriate.
  • Attend professional meetings such as State work groups, State/Regional meetings, community provider association meetings, and others relating to scope of work as assigned. Train/update other members of the Provider Relations Team as appropriate
  • Maintain a thorough understanding of regulations relating to Contracting and the DHS Contract.

Are you excited about this role but not sure if your work experiences align to the role or qualifications? We encourage you to apply anyway. At Lakeland Care, our values drive how we do our work and how we hire. We strive to build an inclusive, authentic workforce that embraces diversity and differences in strengths. So be sure to highlight your skill set and competencies you’re confident in!

Requirements

  • Bachelor’s degree in a human service field, business related field, or equivalent combination of education and experience (includes knowledge, skills, and abilities). 
  • Experience working with the population(s) served in the Family Care program preferred.  
  • Strong financial analysis skills required.  
  • Strong mediation and negotiation skills, including the demonstrated ability to successfully negotiate rates, are strongly preferred.  
  • Knowledge of service provider industry, subcontracting, and licensing and regulatory systems beneficial.  
  • Knowledge of network provider contracting in a managed care model is a plus. 
  • Current driver’s license, acceptable driving record and proof of adequate insurance required. 

Acknowledgement:

This job posting describes the general nature and level of work performed by the individual assigned to this position and should not be interpreted as all inclusive and is subject to change by the employer as the needs of the employer and requirements of the position change.

APPLICATION DEADLINE DATE: Accepting through 4/11/2024. Resume required.

For questions on this role, please reach out to the Talent Acquisition Specialist at Becky.Vang@lakelandcareinc.com.

**COMPENSATION CAN BE DISCUSSED WITH HUMAN RESOURCES.**

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Lakeland Care is a Wisconsin-based non-profit organization that focuses on creating a world we all want to live in. With long-standing roots as a managed care organization (MCO), Lakeland Care provides long-term care services and supports to eligible frail elders and individuals with physical and intellectual or developmental disabilities to achieve their daily and lifelong goals through Wisconsin’s Family Care program. Currently we serve in 22 counties and have 10 offices in the Central to North East region of Wisconsin.

Our Mission

Empowering individuals. Strengthening communities. Inspiring futures.

Our Vision

To create a world we all want to live in.

Our Core Values

Kindness – We believe kindness is always possible and that no compassionate act is ever wasted.

Inclusion – We believe that open hearts and open minds are the only path to a brighter future.

Trust – We believe that honesty is still in style and that promises still have power.

We are an equal employment opportunity employer functioning under an Affirmative Action Plan. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, disability status, protected veteran status or any other characteristic protected by law. We are an organization that participates in E-Verify.

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