National Contracting Mgr

Location: Woodland Center Blvd, Tampa, FL or can be remote

Reporting to: Sr Dir, National Contracting

Dept: CNS-National Contracting

Manages all assigned contracting activities for multi-market and enterprise-wide ancillary, vendor and hospital contracts. Manages the contract life-cycle from: 1) the identification of providers, including through an RFP process that includes multiple department and market participation, 2) the vetting of unsolicited bids from prospective providers, 3) the direction of specific modeling requests associated with vetting the value of the potential contract, 4) the negotiation of sophisticated rate and language provisions, 5) the oversight of the specific configuration process to ensure savings are realized in expedited manner. Researches current agreements for potential improvement in profitability. Involves Market Leadership in the identification and vetting of expense reduction opportunities.

Essential Functions:

  • Oversees multi-market and enterprise-wide contract negotiations in specific areas such as ancillary services, health systems and delegated vendors. Ensures we are meeting set financial targets.
  • Engages with Health Analytics weekly to value contracts and programs offered by potential vendors or providers.
  • Partners with Legal Services on contract language negotiations with vendors and providers and takes ownership of the contract execution process.
  • Leads project teams for vendor selection (RFP) to include relevant stakeholders and drives consensus on action plans
  • Achieves company medical expense reduction targets through aggressive national ancillary contracting and risk contract management.
  • Identifies potential new contracts, vendor relationships, or internal programs that will reduce medical expense and/or improve operating efficiency.
  • Works in close collaboration with the Market finance and network staff to evaluate and vet contract opportunities.
  • Helps set yearly medical expense reduction targets for national contracting
  • Performs other duties as assigned.
Additional Responsibilities:
    Candidate Education:
    • Required A Bachelor's Degree in a related field
    • Required or equivalent work experience with at least 7 years of Provider/hospital/ancillary contracting, network development, financial analysis, medical economics, contract negotiations, strategic planning, market development or business management
    Candidate Experience:
    • Required 5 years of experience in Provider/hospital/ancillary contracting, network development, financial analysis, medical economics, contract negotiations, strategic planning, market development or business management
    • Required Other Experience in negotiations
    • Preferred Other Experience in a managed care environment strongly preferred
    Candidate Skills:
    • Advanced Ability to represent the company with external constituents
    • Advanced Demonstrated negotiation skills
    • Advanced Knowledge of community, state and federal laws and resources
    • Advanced Knowledge of healthcare delivery Ability to explain complicated financial terms and utilization data to physicians and staff
    • Advanced Demonstrated interpersonal/verbal communication skills Ability to speak publicly
    • Advanced Ability to lead/manage others in a matrixed environment
    • Intermediate Ability to work independently
    • Intermediate Demonstrated analytical skills
    • Intermediate Demonstrated organizational skills
    • Intermediate Ability to analyze and interpret financial data in order to coordinate the preparation of financial records
    • Intermediate Other Knowledge of provider contrast and health care reimbursement
    • Intermediate Other Understanding of regulatory compliance management and reportng requirements
    • Intermediate Other Ability to manage complex transaction and service models
    • Intermediate Other Demonstrated proficiency in establishing and driving medical cost management programs
    Licenses and Certifications:
    A license in one of the following is required:
      Technical Skills:
      • Required Intermediate Microsoft Word Proficient in Microsoft Office such as Excel, PowerPoint, Access, Word and Outlook
      • Required Intermediate Microsoft Excel Ability to analyze data in Excel to identify trends, and variance from goals
      • Required Intermediate Microsoft PowerPoint
      • Required Intermediate Microsoft Access
      • Required Intermediate Microsoft Outlook

        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 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.