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Corporate Functions & Operations WellCare - Operations Leadership Careers

Director - Product New Business Development Job

Full Job Title: Director, Product New Business Development

Job Number: 1802484

Location: Tampa, FL

Date Posted: 4-12-2018

Department: HPS Medicaid

Reports to: Sr. Director Product New Business Development

Location: 8745 Henderson Road, Tampa FL 33634

Leads program development process from ideation to execution. Leads integration of health plan clinical programs and operations through collaboration with departmental leaders and external partners to optimize quality based clinical outcomes, utilization management metrics and client goals. This individual operates within the medical management structure as a liaison to the Clinical Services Organization for alignment of program goals and reporting on clinical and financial outcomes. This role builds consensus on program designs; facilitates feedback on clinical performance; and participates in on-going quality improvement processes. Manages program portfolio to ensure effectiveness of program.

Essential Functions:
  • Serves as a product subject matter expert (SME), understanding all aspects of the product benefit design, administration, regulation (state and federal, as applicable), marketing requirements/restrictions, materials/communications, related financial, competitive landscape, etc.
  • Collaborates with analytic teams to identify gaps in health of membership populations creating stratification of cohorts for outreach and intervention.
  • Develops actionable dashboards measuring population health improvements. Delivers reports to internal stakeholders for evaluation, feedback and influence on program development or change.
  • Through strategic approaches developed by Population Health Solutions, develops and monitors deployment and performance of programs (i.e. maternity program, complex care program, critical gaps in Care programs, LTSS program, etc.)
  • Leads initiative based business and clinical program owners in assessment of program performance and improvement strategies.
  • Collaborates with Innovation and Product leads to influence program development
  • Develop specific goals/targets/timelines to meet benchmarks established by the executive leadership team.
  • Evaluates program design and deployment plans for adherence to regulatory or contractual requirements.
  • Maintains knowledge of competitive activity and program designs.
  • Communicates to accreditation and delegation stakeholders program design, implementation status and performance metrics, as well as, quality improvement project details.
  • Works with local Medical Directors and network leadership to establish healthy provider relationships and communication channels.
  • Provides an external voice within key industry groups on integrative health programs.
  • Performs other duties and special project as assigned.
Additional Responsibilities:Candidate Education:
  • Required A Bachelor's Degree in Health Administration or related field
  • Preferred Other Master Degree in Health or Business Administration or related field
Candidate Experience:
  • Required 5 years of experience in Management experience Healthcare or managed care settings, program design and/or implementation and/or accreditation or quality management oversight, knowledge of Medicare and Medicaid benefit designs
  • Required 5 years of experience in Business plan development, written and verbal presentations
  • Required 5 years of management experience Leading and/or managing others
Candidate Skills:
  • Advanced Ability to communicate and make recommendations to upper management
  • Advanced Ability to drive multiple projects
  • Advanced Ability to influence internal and external constituents
  • Advanced Ability to implement process improvements
  • Advanced Ability to influence internal and external constituents
  • Advanced Ability to lead/manage others in a matrixed environment
  • Intermediate Ability to proof large bodies of materials
  • Intermediate Ability to work within tight timeframes and meet strict deadlines
  • Intermediate Other Ability to create appropriate and impactful presentations based on audience needs
  • Intermediate Demonstrated analytical skills
  • Intermediate Demonstrated interpersonal/verbal communication skills
  • Intermediate Demonstrated organizational skills
  • Intermediate Demonstrated project management skills
  • Intermediate Demonstrated time management and priority setting skills
  • Intermediate Other Strong leadership skills, including the ability to prioritize, delegate, assess risk and make educated remediation recommendations.
  • Intermediate Other Ability to design new programs with a high level of accuracy
Licenses and Certifications:
A license in one of the following is required:
Technical Skills:
  • Preferred Advanced Microsoft Excel
  • Preferred Advanced Microsoft Word
  • Required Advanced Microsoft PowerPoint
  • Preferred Intermediate Microsoft Outlook
  • Preferred Intermediate Microsoft Visio
  • Preferred Intermediate Other Knowledge of project planning software sufficient to document project steps and report progress

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Last Updated On: 12/9/2015