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
- 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.
- Required a Bachelor's Degree in a related field
- Required 4 years of experience in a customer service, provider relations and/or network development environment
- Required 1 year experience in leading/supervising others
- 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
- 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