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Provider Relations-Networking-Contracting WellCare - Provider Relations, Networking, & Contracting Leadership Careers

National Provider Contracting & Relations - Vice President Job

Full Job Title: VP National Provider Contracting

Job Number: 1704528

Location: Tampa, FL

Date Posted: 10-4-2017

Direct responsibility for developing and executing all national and/or multi-state hospital, IPA and ancillary contracts including strategy development, direct negotiations and coordination with local market leadership. Serves as a strategic contributor and SME for the overall provider contracting function assisting the local market teams in contracting strategy development for both Medicaid and Medicare to improve WellCare's unit cost position with a focus on deploying value based contracting approaches with appropriate aligned incentives. Directs a team of experienced contractors that can be deployed locally as needed to deliver material market contracting initiatives; coordinating across departments as necessary to deliver comprehensive, cost effective and accessible networks. Cultivates collaborative relationships with WellCare clinical, quality and shared service stakeholders and external provider partners.

Reports to: VP, Network Performance

Dept.: CNS – National Contracting
Location: Tampa, FL

Essential Functions:

  • Develops, directs and delivers network contracting strategies to support local market contracting teams as well as directly leading all national and/or multi-state hospital, IPA and ancillary contracting efforts including direct negotiation responsibilities.
  • Identifies changes in the contracting environment and evaluates competitive strategies enabling WellCare to adjust strategic plans.
  • Serves as the national contracting subject matter expert for Medicare and Medicaid lines of business driving consistency in contracting approaches nationally and within WellCare's local markets.
  • Builds new network models with traditional and advanced provider partnership to support growth, access and cost improvement objectives.
  • Leads team of experienced contractors who can be deployed to support or directly lead major contracting efforts as WellCare's business needs dictate.
  • Ensures consistency in contracting approaches nationally and within local markets.
  • Collaborates with medical economics and actuary to analyze unit cost trends to identify and achieve medical expense improvements.
  • Performs other duties as assigned.
Candidate Education:
  • Required A Bachelor's Degree in Business administration, Finance or a related field
  • Preferred A Master's Degree in a related field
Candidate Experience:
  • Required 10 years of experience in Managed care, provider or other risk organization
  • Preferred 8 years of experience in Risk based hospital, IPA/group and ancillary contracting; direct experience with value based or alternative payment models a plus.
  • Required 8 years of experience in Demonstrated track record of leadership experience concentrated in the network contracting function.
  • Required Other Strong financial acumen and a comprehensive knowledge of provider network contracting methodologies
  • Required Other Proven ability to affect change and meet business goals, monitor progress and take corrective actions when necessary.
  • Required Other Ability to cultivate relationships with internal and external stakeholders particularly with health systems and other provision of care organizations.
Candidate Skills:
  • Advanced Ability to analyze and interpret financial data in order to coordinate the preparation of financial records
  • Advanced Ability to analyze and interpret financial data in order to coordinate the preparation of financial records
  • Advanced Ability to represent the company with external constituents
  • Advanced Ability to lead/manage others in a matrixed environment
  • Advanced Demonstrated leadership skills
  • Advanced Ability to drive multiple projects
  • Advanced Demonstrated negotiation skills
  • Advanced Knowledge of healthcare delivery
  • Advanced Knowledge of community, state and federal laws and resources
  • Advanced Demonstrated analytical skills
  • Advanced Demonstrated organizational skills
  • Advanced Demonstrated interpersonal/verbal communication skills
  • Advanced Ability to influence internal and external constituents
  • Advanced Demonstrated written communication skills
  • Advanced Demonstrated problem solving skills
  • Advanced Other Cultivate and promote a leadership style and approach which cultivates collaboration across inter-dependent functions

Technical Skills:

  • Required Intermediate Microsoft Excel
  • Required Intermediate Microsoft Outlook
  • Required Intermediate Microsoft PowerPoint
  • Required Intermediate Microsoft Word

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Last Updated On: 12/9/2015