Chief Operations Officer - Population Health Services

This position is responsible for the overall operation of Population Health Solutions (PHS), including strategic direction, budget management, market engagement, clinical operations, and drive overall execution of Board and Executive meetings across PHS. The COO works closely with the leadership team to lead and direct the overall improvement of operations to meet business goals and projections.

Reports to: Chief Medical Officer
Dept.: HS - Administration
Location: Tampa (Henderson Road), FL

Essential Functions:

  • The Chief Operating Officer, will serve as the lead Operations partner to the Chief Medical Officer and the lead Operations role among each of the leaders of the functional areas within PHS.
  • Responsible for ensuring the Corporate Utilization Management/Case Management programs are consistent across all Medicare and Medicaid states. All programs must be in accordance with Federal, State, or Company requirements.
  • Develops strategic relationships with market leaders to ensure best practices are implemented and market to market comparisons and KPI’s are monitored and acted upon as required.
  • Participates in the development and preparation of short-term and long-range plans and budgets based upon broad organization goals and objectives. Recommends their adoption to the Chief Medical Officer.
  • Develops strategic relationships across all markets with both Regional and State leadership to ensure ongoing process improvement, metric driven decision making with measurable outcomes.
  • Directs the development and implementation of processes that include procedures and controls that will promote communication and adequate information flow, and thereby solidify management control and the strategic direction of the organization.
  • Works closely with the Chief Medical Officer to develop KPI’s that will be used to inform both the Board of Directors and Executive leadership about the organization's overall performance.
  • Develops and establishes operating policies consistent with the Chief Medical Officer broad policies and objectives and insures their execution. Develops metrics, appraises and evaluates the results of overall operations regularly and systematically, and reports these results to the leadership team and the Chief Medical Officer.
  • Ensures that all activities and operations are performed in compliance with local, state, and federal regulations and laws governing business operations.
  • Develops and maintains a sound strategy of organization. Establishes policies to insure adequate management development and to provide for capable management succession for those functions/business units falling under his/her responsibility.
  • Directs the development and establishment of business process improvement activities to optimize performance.
  • Performs other duties as assigned.
Additional Responsibilities:
    Candidate Education:
    • Required A Bachelor's Degree in business administration, finance or a related field
    • Preferred A Master's Degree in a related field
    Candidate Experience:
    • Required 10 years of experience in overall managed care, network management and/or business operations
    • Required 7 years of experience in senior management with P&L accountability for a managed care organization
    Candidate Skills:
    • Advanced Demonstrated leadership skills
    • Advanced Ability to work in a matrixed environment
    • Advanced Ability to work in a fast paced environment with changing priorities
    • Advanced Demonstrated ability to deal with confidential information
    • Advanced Other Provides proactive approach and support to emerging business activities established to remain competitive in the marketplace
    • Advanced Other Proven ability to affect change and meet business goals, monitor progress and take corrective actions when necessary
    • Advanced Other An extremely organized, disciplined, hands on and process oriented leader who is not afraid of digging into details when necessary
    • Advanced Other Strong business acumen, intelligence, and capacity. Thinks strategically and implements tactically.
    • Advanced Other Problem solves and approaches work from a “return on investment” perspective.
    • Advanced Other Highly Flexible regarding schedules, priority shifts
    • Advanced Other Ability to think creatively and out of the box.
    • Advanced Other Ability to remain calm under pressure.
    • Advanced Other A “failure is not an option” mentality and demonstrated proactive management style.
    • Advanced Other A vision and understanding of the future and subsequent changes required to meet business needs
    • Advanced Other Comprehensive knowledge of delivery system operations, provider contracting, strategic planning and overall service delivery
    Licenses and Certifications:
    A license in one of the following is required:
    • Preferred Certified Public Accountant (CPA)
    Technical Skills:
    • Required Intermediate Microsoft Word
    • Required Intermediate Microsoft Excel
    • Required Intermediate Microsoft Outlook
    • Required Intermediate Other Knowledge of and/or ability to utilize COGNOS for budgetary decisions or review.


    About us
    Headquartered in Tampa, Fla., WellCare Health Plans, Inc. (NYSE: WCG) focuses exclusively on providing government-sponsored managed care services through Medicaid, Medicare Advantage and Medicare Prescription Drug Plans to families, children, seniors and individuals with complex medical needs. WellCare is a Fortune 500 company, and in 2018, was recognized as a Fortune "World's Most Admired Company", ranking in the top five among the health insurance and managed care industry-a testament to the hard work and dedication of the company's nearly 9,000 associates who each day live WellCare's values and deliver on its mission to help its members live better, healthier lives. The company serves approximately 4.4 million members nationwide as of Dec. 31, 2017. For more information about WellCare, please visit the company's website at EOE: All qualified applicants shall receive consideration for employment without regard to race, color, religion, creed, age, sex, pregnancy, veteran status, marital status, sexual orientation, gender identity or expression, national origin, ancestry, disability, genetic information, childbirth or related medical condition or other legally protected basis protected by applicable federal or state law except where a bona fide occupational qualification applies. Comprehensive Health Management, Inc. is an equal opportunity employer, M/F/D/V/SO.