Executes and develops strategies to meet or exceed compliant operation of the MLTC, MAP and potential expansion LTC markets. Oversees provider contracting and network management as it relates to LTC operations. Provides support with project and initiative leadership, as well as organizational development. Facilitates problem identification, solution development and initiative implementation on behalf of, or in conjunction with, MLTC senior leadership. Acts as a deployable resource to provide increased initiative bandwidth while developing depth and succession planning in the leadership ranks for the product.
- Accountable for the management and execution of special projects that may interface across multiple functional areas, and liaise with external constituents as needed to build relationships or deliver results.
- Leads and directs the operational aspects of the LTC plans. Responsible for achieving business results as directed by state leadership.
- Develops and implements annual provider contracting initiatives to achieve access, quality and cost management objectives.
- Performs strategic planning and annual forecasting activities for MLTC. Has accountability for assessing market dynamics, competitive position and operational performance Builds or enhances relationships with providers and community based partners to support WellCare's mission and create compliant opportunities for growth within the state.
- Takes the appropriate actions to ensure compliance within all areas of the business for which there is accountability.
- Evaluates sales, contracting and operational processes for "best practice" development across MLTC plan.
- Oversees and manages the operation team which includes analytics, enrollment, provider relations and authorization.
- Performs other duties as assigned.
This position is contingent upon the bid award in the state of New Hampshire to WellCare Health Plans, Inc.Candidate Education:
- A Bachelor's Degree in a related field or in business administration required.
- 10 years of experience in strategic planning and development, provider contracting, and financial management required.
- Intermediate - Ability to lead/manage others
- Intermediate - Ability to work as part of a team
- Intermediate - Demonstrated interpersonal/verbal communication skills
- Intermediate - Ability to work in a matrixed environment
- Intermediate - Demonstrated analytical skills
- Intermediate - Analytical with an ability to drive change.
- Intermediate - Must be able to effectively maintain/build relationships across business and/or functional areas
- Intermediate - Adaptable
- Intermediate - Demonstrated contributor in a health care or managed care environment
- Intermediate proficiency with Microsoft Outlook, Word, Excel, and PowerPoint.
- Intermediate experience with quantitative analysis and financial modeling capability required.