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Corporate Functions & Operations WellCare - Operations Management Careers

Director - Strategic Market Analysis Job

Full Job Title: Director, Strategic Market Analysis (Encounters, Risk Adjustment)

Job Number: 1703781

RIchmond, VA
Statewide, VA

Date Posted: 10-2-2017

Incumbent is responsible for providing market-embedded thought leadership, competitive financial analysis and statistical studies for areas with considerable potential ROI, which may include: market encounter data, Medicaid risk adjustment optimization, member auto assignment opportunity and Medicaid quality incentive maximization. Leads the development of complex reporting and analysis, aimed at identifying root cause and trend identification which can be translated into actionable ROI for the market, division and/or product. Leverages strong public policy knowledge to translate complex data sets into meaningful, competitive analysis.

Essential Functions:
  • Serves as an embedded, market-based leader for driving favorable encounter data inventory outcomes via partnership with shared services encounter teams, sophisticated analytical ability (including a robust understanding of multiple, complex data sources) and the ability to translate findings into actionable solutions that drive favorable business outcomes.
  • Researches, analyzes, crafts and operationalizes strategies to drive market optimization in areas included: encounters, Medicaid Risk Adjustment, Medicaid Quality Incentives and Auto Assignment.
  • Develops ad-hoc reports to conduct data analysis and validation for areas impacting market performance.
  • Effectively partners with departments within both the market(s) and shared services, including actuarial, provider relations, claims and encounters to lead targeted projects and drive results.
  • Researches methodologies and conducts advanced metric reporting by leveraging direct reports and/or matrix organizations (including market and shared services partners).
  • Leverages outstanding ability to analyzes trends and translate findings into sound recommended process and/or operational improvements for business leaders.
  • Prepare detail and summary level reports including written interpretation of analytic results.
  • Capitalizes upon solid knowledge of public policy to provide evidenced-based, data-driven thought leadership to market, divisional and product executive teams via outstanding written and oral communication skills.
  • Evaluates financial impact of implemented initiatives.
  • Performs other duties as assigned.

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

Candidate Education:
  • A Bachelor's Degree in Public Policy, Statistics, Mathematics, or relevant field is required
  • A Master's Degree in MBA, Masters in Public Policy, Statistics, Mathematics or relevant field is preferred
Candidate Experience:
  • 7 years of experience in a related analysis role supporting business departments is required
  • 7 years of experience in preferably in a Healthcare or public policy environment is required
Candidate Skills:
  • Demonstrated written communication skills
  • Demonstrated interpersonal/verbal communication skills
  • Ability to analyze information and covert related activities into a comprehensive work plan
  • Ability to work as part of a team
  • Ability to work independently
  • Ability to work within tight timeframes and meet strict deadlines
  • Demonstrated organizational skills
  • Ability to remain calm under pressure
  • Ability to work overtime as required
Technical Skills:
  • Intermediate skills with Microsoft Outlook, Word, PowerPoint, Excel and Access is required
  • May require knowledge of one or more of the following: SQL, Crystal, Diamond, Cognos, CRMS, PC, Sidewinder
  • Intermediate Statistical Analysis Systems (SAS) is preferred


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Last Updated On: 12/9/2015