Manager, Provider Relations

WellCare Health Plans, Inc. (NYSE:WCG) a Fortune 1000 company, is the nation?s leading provider of government health insurance products dedicated to government-sponsored health plans such as Medicare, Medicaid, State Children?s Health Insurance Programs, Medicare Prescription Drug Plans and others. Founded in 1985, our team of 2,500 associates and over 20,000 physician partners serve 1.4 million members across the U. S. Our company headquarters are based in Tampa, FL. For more information about WellCare, please visit the Company?s website at www.wellcare.com.



We are looking to add a Manager, Provider Relations to our team.  If you truly believe in teamwork, consistently demonstrate a high level of integrity and want to be a part of a dynamic, growing organization, then this may be the opportunity for you!

 

Job Summary:

Position plans, provides resources and manages network development, provider contracting/negotiation and provider service functions.  Assignments are broad in nature, usually requiring considerable creativity, originality and ingenuity.

 

Essential Functions:

 Manages and develops direct reports who include exempt and/or non-exempt individual contributors.Conducts and directs provider contracting/negotiations and provider servicing.Assists is establishing effective departmental practices and work closely with various departments (operations, regulatory, sales, etc.) to ensure contracts meet operating, financial and legal standards. Perform data analysis and develop specific actions to manage medical cost trend.Assists in developing practices to assist risk partners in managing financial risk.Directs area activity to ensure compliance with all regulatory and organizational requirements and standards.Identify areas to improve provider service levels within operating budget parameters.Educate and enhance relationships within the provider community.Manages resources to meet operational goals and budgets.  Assist in developing provider contracting and service. Implements corporate initiatives to achieve optimum results.

 

Education and Experience:

?  Bachelors level education or equivalent directly related experience

?  7-10 years of progressively responsible managerial experience

?  Strong functional and technical knowledge of healthcare delivery

?  Demonstrated people management and facilitative skills

?  Excellent interpersonal skills and demonstrated ability to influence internal and external constituents

?  Proven analytical skills and financial skills

 

Computer Skills:Excellent knowledge of email systems such a Microsoft Outlook sufficient to communicate with both internal and external contacts.Excellent knowledge of Word and/or Excel sufficient to enter data, copy or cut and paste data and print results as required.Knowledge of project planning software sufficient to document project steps and report progress.