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Provider Relations-Networking-Contracting WellCare - Provider Administration & Support Careers

Provider Operations - Supervisor Job

Full Job Title: Supervisor, Provider Operations

Job Number: 1803894

Location: Phoenix, AZ

Date Posted: 6-5-2018

This position is for Care1st Health Plan in Phoenix, AZ, a WellCare Healthplans, Inc. company.

Supervises a team of Provider Operations Coordinators in support of the Field Provider Relations and/or Network Management team as it relates to troubleshooting, coordination and administration duties.

DEPARTMENT: Provider Relations

REPORTS TO: Manager, Network Management

LOCATION: Phoenix, AZ

JOB TYPE: Level 15/ Salary/Exempt

Essential Functions:

  • Oversees the day-to-day operations of the Provider Operations team.
  • Supervises and develops direct reports.
  • Provides support to field teams in the function of troubleshooting, coordination and administration.
  • Coordinates with management from Network Management, Provider Relations, and other network teams to ensure appropriate prioritization is given to PLFs for network expansion projects.
  • Ensures regularly scheduled meetings with Shared Services teams, such as Configurations and Credentialing, to discuss issues, workload and processes for improved synchronization.
  • Ensures compliance with all regulatory and organizational requirements and standards through process refinement, regular audits, and associate coaching.
  • Partners with local training team to identify and develop applicable training courses for direct reports.
  • Assists is establishing effective departmental practices and works closely with various departments to ensure department and company goals are being met.
  • Performs work flow analysis to monitor consistency and efficiency in processes and procedures.
  • Performs quality audits on a regular basis to ensure PLFs are completed correctly and provider demographic and contractual data is correctly reflected in our systems.
  • Identifies areas to improve service levels within operating budget parameters.
  • Manages resources to meet operational goals and budgets.
  • Assists in implementing corporate initiatives to achieve optimum results.
  • Performs other duties as assigned.
Candidate Education:
  • Required a Bachelor's Degree in a related field
Candidate Experience:
  • Required 4 years of experience in a customer service, provider relations and/or network development environment
  • Required 1 year experience in leading/supervising others
Candidate Skills:
  • Intermediate ability to lead/manage others
  • Intermediate demonstrated interpersonal/verbal communication skills
  • Intermediate demonstrated written communication skills
  • Intermediate ability to influence internal and external constituents
  • Intermediate ability to work as part of a team
  • Intermediate ability to work in a fast paced environment with changing priorities ability to work in a fast paced environment with changing priorities
  • Intermediate ability to multi-task Ability to multi-task
  • Intermediate knowledge of healthcare delivery
  • Intermediate demonstrated organizational skills
  • Intermediate demonstrated problem solving skills
  • Intermediate ability to analyze information and covert related activities into a comprehensive work plan
  • Intermediate ability to communicate and make recommendations to upper management

Technical Skills:

  • Required intermediate Microsoft Word
  • Required intermediate Microsoft Excel
  • Knowledge of project planning software sufficient to document project steps and report progress
  • Required intermediate Microsoft PowerPoint
  • Required intermediate Microsoft Outlook

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Last Updated On: 12/9/2015