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

Provider Relations - Director Job

Full Job Title: Director Provider Relations

Job Number: 1703722

Locations:
RIchmond, VA

Date Posted: 8-24-2017

Strategizes for optimal business practices and efficiencies with an emphasis on producing revenue for the corporation. Position plans, provides resources and directs activities in network development, provider contracting/negotiation and provider service functions.

Location: Richmond, VA

Essential Functions:

  • Sets goals for their area and works closely with Managers/Representatives to drive performance and to ensure provider satisfaction metrics are met or exceeded.
  • Conducts field rides with Provider Relations Representatives to gauge their performance and provide coaching and development in order to improve the business results.
  • Plans, conducts and directs provider contracting/negotiations and provider servicing.
  • Develops practices to assist risk partners in managing financial risk.
  • Performs data analysis and develops specific actions to manage medical cost trends.
  • Plans, provides resources and directs activities, network development, provider contracting/negotiation and provider service functions.
  • Develops provider contracting and service strategies and ensures maximum efficiencies in the utilization of human and financial resources.
  • Strategizes for membership growth, retention, and to affect sophisticated or complex provider relationships.
  • Maintains compliance for State and CMS audits.
  • Special projects as assigned or directed.

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

Candidate Education:
  • Required A Bachelor's Degree in a related field or equivalent work experience directly related to the level and duties of the job
Candidate Experience:
  • Required 7 years of experience in provider relations or similar background
  • Required 4 years of experience in management
Candidate Skills:
  • Intermediate Demonstrated leadership skills
  • Intermediate Ability to lead/manage others
  • Intermediate Demonstrated interpersonal/verbal communication skills
  • Intermediate Ability to influence internal and external constituents
  • Advanced Demonstrated analytical skills
  • Advanced Other Facilitative skills
  • Intermediate Other Provides proactive approach and support to emerging business activities established to remain competitive in the marketplace
  • Intermediate Other Ability to convert related activities into a comprehensive work plan
  • Advanced Other Financial skills
  • Advanced Other Knowledge of CMS and state regulations
Technical Skills:
  • Required Intermediate Microsoft Word
  • Required Intermediate Microsoft Excel

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Last Updated On: 12/9/2015