Market VP - Medicaid LOB

Helps set strategy and drives the profitability of a single state or market segment with revenues above $100M with overall responsibility for network development, provider relations, marketing and potentially sales. Provides leadership in all facets of the business including planning, assistance with the day to day management of state operations, project and initiative leadership, as well as organization development. This role will facilitate problem identification, solution development, and initiative implementation as well as facilitate and make critical decisions on behalf of the Senior Team. The Market VP is an integral part of the Senior Leadership Team and works collaboratively with the Leadership Team, WellCare Corporate Senior Leadership and others as required.

Essential Functions:
  • Key role supporting market on effective medical management, financial, compliance and quality through effective network contracting and long-term approach to successful partnerships with key providers. Matrix responsibility for overall success of the market.
  • Provides day-to-day leadership for network development, provider relations, marketing and potentially sales
  • Critical role in achieving business results within the assigned market
  • Recognized as a senior member of WellCare’s team in the market and responsible for establishing and maintaining key relationships with providers, hospitals, and community organizations.
  • Oversees the development and maintenance of a viable provider network to ensure the health care needs of WellCare members. Develops and manages provider contracts and partnerships to achieve quality and cost management objectives. Works closely with providers to enhance relationships and maximize their ability to effectively manage the cost of medical delivery.
  • Owns and manages special projects assigned by the health plan that may interface across multiple functional areas of WellCare, and liase with external stakeholders or consultants as needed.
  • Recommendations carry considerable weight in budget decisions impacting their market.
  • Provides leadership and direction to the management team to ensure the organization's strategic plan is translated into tactical goals and objectives that guarantee performance objectives are met or exceeded.
  • Assists and leads where appropriate, with aspects of state and federal government relationships, including dealing with regulators, as necessary, to establish and continue effective working relationships. Ensures that all state and federal regulations are met.
  • Performs other duties as assigned.

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

Candidate Education:
  • Required A Bachelor's Degree in a related field with 10 years of directly related experience with 5 years of previous management experience.
  • Preferred A Master's Degree in a related field with 5 years of directly related experience with 3 to 5 years previous management experience
  • Preferred or equivalent work experience
Candidate Experience:
  • Required 10 years of experience in managing a P&L in a health care environment; government programs and managed care experience
  • Required 5 years of management experience
Candidate Skills:
  • Advanced Ability to lead/manage others
  • Advanced Ability to influence internal and external constituents
  • Advanced Ability to analyze and interpret financial data in order to coordinate the preparation of financial records
  • Advanced Ability to drive multiple projects
  • Advanced Ability to lead/manage others in a matrixed environment
  • Advanced Ability to represent the company with external constituents
  • Advanced Demonstrated analytical skills
  • Advanced Demonstrated interpersonal/verbal communication skills
  • Advanced Demonstrated leadership skills
  • Advanced Demonstrated negotiation skills
  • Advanced Knowledge of healthcare delivery
  • Advanced Other Extensive technical/functional expertise with strong management skills to coordinate broad function areas
Licenses and Certifications: Technical Skills:
  • Required Intermediate Microsoft Excel
  • Required Intermediate Microsoft Outlook
  • Required Intermediate Microsoft PowerPoint
  • Required Intermediate Microsoft Word

About us
Headquartered in Tampa, Fla., WellCare Health Plans, Inc. (NYSE: WCG) focuses primarily on providing government-sponsored managed care services to families, children, seniors and individuals with complex medical needs primarily through Medicaid, Medicare Advantage and Medicare Prescription Drug Plans, as well as individuals in the Health Insurance Marketplace. WellCare serves approximately 5.5 million members nationwide as of September 30, 2018. WellCare is a Fortune 500 company that employs nearly 12,000 associates across the country and was ranked a "World's Most Admired Company" in 2018 by Fortune magazine. 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.