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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.
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 Sevrices 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.
This position is contingent upon the bid award in the state of Illinois to WellCare Health Plans, Inc.
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 required.
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.