Operations Support Specialist

Serves as a department SME for a wide range of tasks and special functions to include vendor support, training, quality reviews, new business implementations, reporting analytics, process improvement, etc.

Essential Functions:
  • Serves as liaison between department and business partners, both internal and external.
  • Plan, manage, monitor, perform UAT and complete key improvement projects in an accurate and timely manner.
  • Identifies, evaluates, recommends and implements data-driven process improvement initiatives.
  • Provide support on tasks and special functions such as vendor oversight, contracting, inventory monitoring, reporting, new business implementations, quality reviews, root cause analysis, training, operational processes, etc.
  • Maintains/ Creates resources applicable to assigned area, such as timely updates to training, announcements, step actions, reference call tools, FAQs etc.
  • Represents team in cross functional environment and collaborates with leadership to implement new processes.
  • Partners with WellCare vendors supporting operations. Supports and assists all LOB’s with specific focus on Health Services, Pharmacy, Medicaid, Exchanges, Medicare and PDP, etc.
  • Investigates problems of a moderately complex nature and provide findings, impact, remediation and preventative actions in a clear and concise manner.
  • Analyzes data and reports to identify trends, operational issues, financial impact of implemented initiatives, etc. May need to run existing SQL queries to generate data into Excel to conduct research and analysis.
  • Other duties as assigned.
Additional Responsibilities:
    Candidate Education:
    • Required A High School or GED
    • Preferred A Bachelor's Degree in a related field
    Candidate Experience:
    • Required 3 years of experience in a related field based on assigned area
    • Preferred Other Previous experience in a customer service environment and health insurance
    Candidate Skills:
    • Intermediate Demonstrated analytical skills
    • Intermediate Demonstrated written communication skills
    • Intermediate Demonstrated interpersonal/verbal communication skills
    • Beginner Ability to communicate and make recommendations to upper management
    • Intermediate Other Strong understanding of managed care and its place in the health care industry
    • Intermediate Other Understanding of interdependencies on other business units such as Health Services, Provider Relations, Sales, Vendors, Claims
    • Beginner Other Demonstrate ability to implement process improvements
    Licenses and Certifications:
    A license in one of the following is required:
      Technical Skills:
      • Required Intermediate Microsoft Outlook
      • Required Intermediate Microsoft Excel
      • Required Intermediate Microsoft Word
      • Preferred Intermediate Microsoft PowerPoint
      • Preferred Intermediate Microsoft Visio
      • Preferred Intermediate Xcelys
      Languages:

        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.