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Corporate Functions & Operations WellCare - Data Analyst Careers

Configuration - Supervisor Job

Full Job Title: Supervisor, Configuration

Job Number: 1804434

Location: Tampa, FL

Date Posted: 2018-06-20

Location: Idlewild Ave, Tampa, FL 33634
Department: Operations - Configuration
Reports to: Manager, Configuration

Position provides direct management of exempt and non-exempt associates responsible for accurate and timely maintenance of provider network, related automated pricing methodologies, daily workflow of team, and configuration liaison between the Market and Shared Services.

Essential Functions:
  • Oversees systematic processing of provider files sent from external vendors as well as those created internally through Batch processes.
  • Maintains technical understanding of price rules, fee schedules, and provider contract loads, assures staff is trained and up to date on these.
  • Manages and monitors key performance metrics and implements improvement plans either with an individual or at an aggregate level.
  • Handles all direct employee personnel issues and processes (where applicable), including performance management, appraisal processes, development planning, and career pathing.
  • Performs root cause analysis on global issues that affect downstream processes, including automated claims payments and Provider Directories.
  • Supervises direct reports by assigning workload, monitoring quality and associate coaching.
  • Serves as liaison between departments when it becomes necessary due to member or workflow issues.
  • Develops, recommends, and implements process improvements to improve efficiencies and services provided.
  • Oversees training associates on new processes and refresher training.
  • Facilitate and participate in meetings with other departments and line of business as needed.
  • Act in a liaison capacity for the Mgr/ Sr Mgr representing operations with other areas and business units.
  • Demonstrates desired behaviors by exceeding others expectations and leads by example
  • Completes gap analysis on training for the business.
  • Other duties as assigned.
    Candidate Education:
    • Required: High School or GED
    • Preferred: Bachelor's Degree in a related field
    Candidate Experience:
    • Required:4 years of experience in Provider Network Development, Fee Schedules, High Volume Automated Claims Processes
    • Required: Experience leading others on complex automated projects
    Candidate Skills:
    • Demonstrated analytical skills
    • Demonstrated written communication skills
    • Demonstrated interpersonal/verbal communication skills
    • Ability to communicate and make recommendations to upper management
    • Technical understanding of automated claims processing, fee schedules, provider network structures, provider reimbursement methodologies. Understanding of contract terms and how they are loaded into the system.
    • In-Depth knowledge of Health Insurance
    • Strong understanding of managed care and its place in the health care industry
    Technical Skills:
    • Microsoft Word
    • Microsoft Outlook
    • Microsoft Excel
    • Proficiency with all WellCare based systems utilized in job functions.

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      Last Updated On: 12/9/2015