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Provider Relations-Networking-Contracting WellCare - Provider & Hospital Contracting Careers

National Contracting Director Job

Full Job Title: Director National Ancillary Contracting

Job Number: 1703159

Location: Tampa, FL

Date Posted: 7-18-2017

Reports to: VP, National Contracting
Dept.: National Contracting
Location: Tampa, FL
Develops and manages ancillary contracting at the national level and any expansion areas for Medicare and Medicaid. Oversees the implementation of all operational aspects of ancillary contracting including the following: network development, provider loading, vendor setup, SLA's, quality reporting and directory accuracy. Supports the development of company and market strategies through coordination with various areas including but not limited to the following: medical management, sales, product, quality, customer service, legal, medical economics and senior market leadership. Organizes and focuses resources on successful execution of identified strategies.



Essential Functions:

  • Establishes effective departmental practices and works closely with all internal departments to ensure contracts meet operational and financial targets and are legally compliant with governmental agencies.
  • Serves as a lead to national contracting managers with complex negotiations to ensure attainment of established financial targets and inclusion of value based performance metrics.
  • Executes strategic corporate and departmental initiatives around medical cost targets, quality improvement, customer service improvement, and other administrative performance metrics.
  • Monitors reimbursement practices and terms under Medicaid and Medicare.
  • Reviews reimbursement for ancillary vendors and develops MEI's to reduce medical cost trends.
  • Monitors and researches the provider community for new and emerging medical trends.
  • Develops business cases to evaluate and support decisions on new WellCare programs, reimbursement models and vendors.
  • Leads change and executes business objectives through oversight and management of key stakeholders and owners.
  • Performs other duties as assigned.
Additional Responsibilities:Candidate Education:
  • Required A Bachelor's Degree in a related field
  • Preferred A Master's Degree in a related field
Candidate Experience:
  • Required 8 years of experience in Healthcare sector
  • Required 7 years of experience in Network contracting: physician, hospital, or ancillary
  • Required 2 years of experience in Developing and implementing business strategies

Candidate Skills:

  • Advanced Ability to analyze information and covert related activities into a comprehensive work plan
  • Advanced Ability to communicate and make recommendations to upper management
  • Intermediate Ability to drive multiple projects
  • Intermediate Ability to effectively present information and respond to questions from peers and management
  • Intermediate Ability to implement process improvements
  • Intermediate Ability to implement process improvements
  • Intermediate Ability to influence internal and external constituents
  • Intermediate Ability to work independently
  • Advanced Ability to lead/manage others in a matrixed environment
  • Advanced Demonstrated ability to deal with confidential information
  • Intermediate Demonstrated negotiation skills
  • Advanced Demonstrated project management skills
  • Advanced Other Knowledge of provider contracting models
Technical Skills:
  • Required Intermediate Microsoft Excel
  • Required Intermediate Microsoft PowerPoint
  • Preferred Intermediate Microsoft Word
  • Preferred Intermediate Microsoft Access

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Last Updated On: 12/9/2015