Director State IT and Operations

LOCATION: North Carolina

DEPARTMENT: State

REPORTING TO: VP

Works closely with internal and external customers to provide a unique blend of customer service, technical knowledge and business analysis for critical information requests and metric analysis. Ability to positively influence key stakeholders across the organization to complete tasks under aggressive deadlines. Proactively analyzes trends and metrics to alert senior leadership of opportunities to improve business performance. Key role in problem identification and resolution. Position requires extensive knowledge of health plan operations and the systems that support them, including information system security and controls, program data transactions, and data exchanges.

Essential Functions:

  • Acts as a liaison between Corporate Operations and the State President as it relates to government reporting and compliance.
  • Ambassador for WellCare with various state agencies.
  • Acts as a liaison for Regulatory issues surrounding any Operations area, including Claims, Call Center, Enrollment, etc.
  • Investigates, initiates, and manages processes and cost saving improvement initiatives.
  • Sets overall goals, performance standards, and operational priorities, and manages resources to operational goals and budget.
  • Provides input into budget.
  • Performs other duties as assigned.
Additional Responsibilities:
  • Participates in planning and the implementation of programs and strategies.
  • Acts in a liaison capacity with other areas, business units and state specific representatives.
  • Ensures state contractual issues with respect to information management systems are identified and prioritized appropriately, and makes recommendations as needed to sustain and/or improve regional relationships.
  • Ability to travel by automobile, plane or other public transportation as necessary.
  • Able to travel domestically.

This position is contingent upon the bid award in the state of North Carolina to WellCare Health Plans, Inc.

Candidate Education:
  • Required A Bachelor's Degree in a related field
  • Preferred A Master's Degree in a related field
Candidate Experience:
  • Required 7 years of experience in Health Plan Operations
  • Required 3 years of experience in IT management or Systems
Candidate Skills:
  • Advanced Demonstrated leadership skills
  • Intermediate Demonstrated ability to deal with confidential information
  • Advanced Demonstrated interpersonal/verbal communication skills
  • Advanced Demonstrated written communication skills
  • Intermediate Ability to multi-task
  • Intermediate Ability to work in a fast paced environment with changing priorities
  • Intermediate Demonstrated organizational skills
  • Advanced Other Facilitative skills
  • Intermediate Other Public speaking skills
  • Intermediate Other Ability to remain calm under pressure
Licenses and Certifications:
A license in one of the following is required:
    Technical Skills:
    • Required Intermediate Microsoft Word
    • Required Intermediate Microsoft Excel
    • Required Intermediate Other COGNOS
    Languages:

      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 www.wellcare.com. 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.