Director, Health Services

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.

 

Job Summary:

Position plans, provides resources and directs activities for the business of the function (or multiple functions) within Inpatient Services - Health Services.  Assignments are broad in nature, usually requiring considerable creativity, originality and ingenuity.

 

Essential Functions: Manages and develops direct reports who include other management or supervisory personnel and/or exempt individual contributors.Plans, conducts and directs work on complex projects/programs necessitating the origination and application of new and unique approachesSets operational priorities and manages resources to operational goals and budgets  Develops strategies and ensures maximum efficiencies in the utilization of human and financial resources  With approval of Senior VP or VP establishes budget and monitors for adherence Ensures corporate initiatives are implemented to achieve optimum resultsDirects the review assessment, providing advice when necessary of complex, controversial and/or unique administrative processes, medical procedures and payment guidelines.Establishes professional working relationships with all providers.Key liaison for all New York related medical departmental issues such as healthcare compliance, medical assessment procedures, medical programs, approval and denial of medical procedures, etc.

 

Additional Duties:

 Advises management in long-range planning for areas of specialization  Provides technical direction to functional managers, other directors and managementRecommends changes in area(s) policy and procedure

 

Supervision Received/Exercised:

Oversight through examination of fiscal and operational results.

 

Scope of Decisions:Decisions require considerable judgment in the analysis of problems and affect the area in important ways.  Has significant input into policy and latitude to make decisions for the area. Scope is both corporate and area-focused. Responsibilities are complex and results may have long-range implications.

 

Knowledge, Skills, Abilities Required:

?  Assist in evaluating process improvements.

?  Work independently, handle multiple assignments and prioritize workload. 

?  Demonstrate negotiation skills.

 

Education and Experience:

?  Bachelors level education or equivalent directly related experience

?  10+ years of progressively responsible managerial experience

?  In-depth functional knowledge and broad multi-functional knowledge

?  Demonstrated leadership, people management and facilitative skills

?  Ability to retain confidentiality regarding privileged company information

?  Provide proactive approach and support to emerging business activities established to remain competitive in the marketplace