Internal Posting - Provider Network Developer and Contracting Specialist

The Health and Human Services Department is recruiting internally for a Provider Network Developer and Contracting Specialist position.  To apply, please go to the Employment Opportunities page at https://www.governmentjobs.com/careers/trempealeau

The purpose of this position is to ensure adequate provider service availability for social workers and case workers to authorize for people enrolled in various state programs.  The person in this position contacts and works with providers to complete contracts and ensure compliance.  The work is performed under the supervision of the Fiscal Manager.To perform this job successfully, an individual must be able to perform each essential function satisfactorily and in a timely manner. The following duties are normal for this position. These are not to be construed as exclusive or all inclusive. Other duties may be required or assigned.

Work collaboratively with department staff to identify and address gaps in provider network service types, capacity, and geography as necessary for all programs.

Collect and demonstrate knowledge of providers in the county, as well as the competitive landscape.

Manage complex contracting and negotiations.

Analyze and project financial impact of larger or complex provider contracts.

Complete, track, and manage provider contracts in an accurate and timely manner to prevent and address network gaps.

Verify and validate provider information, including licensure, certifications, and education, communicating with providers regarding any deficiencies.

Ensure compliance with regulatory requirements through accurate and up-to-date provider files.

Manage key provider relationships and build relationships that nurture provider partnerships.

Set priorities to align with provider network performance goals.

Educate providers on relevant policies, procedures, and information regarding referrals and claims submission.

Assist with resolving elevated and complex provider service complaints.

Encourage innovative and efficient service delivery.

Communicate effectively with stakeholders with appropriate frequency.

Maintain innovative and non-judgmental approach/attitude when working with providers.

Maintain professional attitude and behavior in all interactions with internal and external stakeholders.

Apply departmental policies and procedures with respect to confidentiality.

Perform records maintenance and clerical activities in accordance with requirements and department policies.  

Assist with fiscal related tasks and/or projects related to contractual and billing requirements.

Participate in regional workgroup meetings to collaborate with other counties to align resources for program requirements.

Assist with audit related activities as needed.

Attend various staff trainings and other meetings as required.


Ability to classify, compute and tabulate data and information, following a prescribed plan requiring the exercise of some judgment.  Ability to compare, count, differentiate, measure and sort information.  Ability to assemble, copy, record and transcribe data and information.

Ability to explain, demonstrate and clarify to others within well-established policies, procedures and standards. Ability to follow specific instructions and respond to simple requests from others.

Ability to utilize a wide variety of descriptive data and information such as contracts, billing statements, purchase orders, agency program forms, spreadsheets, regulations, correspondence and computer software operating manuals. 

Ability to communicate orally and in writing with agency personnel, clients, other agencies and the general public.

Ability to add and subtract, multiply and divide, and calculate percentages, fractions, and decimals.  Ability to interpret basic statistical reports.

Ability to use functional reasoning in performing semi-routine functions involving standardized work with some choice of action.

Ability to exercise judgment, decisiveness and creativity in situations involving a variety of generally pre-defined duties which may be subject to frequent change.


Bachelor’s Degree in Business or Healthcare or related field and experience with provider relations, contracting, and credentialing, or any combination of education and experience that provides equivalent knowledge, skills and abilities.  Proficient in basic computer skills.  Experience and knowledge in state and federal compliance requirements is preferred.