Reports to: Executive Director Medicare
Location: 7100 Commerce Way Brentwood, TN 37027
Partners with Market Leadership to help set the strategy and drives the profitability of a suite of Medicare Markets. Incumbent provides oversight for network development, provider relations, marketing, sales and quality improvement. Provides leadership in all facets of the business including planning, assistance with the day to day management of state operations, project and initiative leadership, as well as organization development. This role will facilitate problem identification, solution development, initiative implementation as well as executing business strategies.
Additional Responsibilities: Candidate Education:
- Provider overall operational support to a suite of Medicare markets regarding effective medical management, financial, compliance and quality through effective network contracting and long-term approach to successful partnerships with key providers.
- Partners with Market Leadership to provide day-to-day leadership for network development, provider relations, marketing, sales and quality improvement.
- Responsible for partnering with Medicare Executive Director to to establish and maintain key relationships with providers, hospitals, and community organizations.
- Provides operational leadership for the development and maintenance of a viable provider network to ensure the health care needs of WellCare members. In conjunction with network leaders, develops and manages provider contracts and partnerships to achieve quality and cost management objectives. Works closely with providers to enhance relationships and maximize their ability to effectively manage the cost of medical delivery.
- Provides operational leadership and support to SG&A planning and budgeting decision making for assigned markets.
- Provides leadership and direction to the management team to ensure the organization's strategic plan is translated into tactical goals and objectives that guarantee performance objectives are met or exceeded.
- Leads change and executes on business objectives through oversight and management of key stakeholders and owners.
- Monitors and manages key deliverables of the strategic plan.
- Performs other duties as assigned.
- Required A Bachelor's Degree in a related field with 10 years of directly related experience with 5 years of previous management experience.
- Preferred A Master's Degree in a related field with 5 years of directly related experience with 3 to 5 years previous management experience
- Preferred or equivalent work experience
- Required 6 years of experience in managing a P&L in a health care environment; government programs and managed care experience
- Required 5 years of management experience
Licenses and Certifications:
- Advanced Ability to lead/manage others
- Advanced Ability to influence internal and external constituents
- Advanced Ability to analyze and interpret financial data in order to coordinate the preparation of financial records
- Advanced Ability to drive multiple projects
- Advanced Ability to lead/manage others in a matrixed environment
- Advanced Ability to represent the company with external constituents
- Advanced Demonstrated analytical skills
- Advanced Demonstrated interpersonal/verbal communication skills
- Advanced Demonstrated leadership skills
- Advanced Demonstrated negotiation skills
- Advanced Knowledge of healthcare delivery
- Advanced Other Extensive technical/functional expertise with strong management skills to coordinate broad function areas
- Intermediate Other Ability to work both strategically and tactically to accomplish objectives
A license in one of the following is required:
- Required Intermediate Microsoft Excel
- Required Intermediate Microsoft Outlook
- Required Intermediate Microsoft PowerPoint
- Required Intermediate Microsoft Word