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Corporate Functions & Operations WellCare - Quality & Audit Careers

Senior Clinical Program Development Manager Job

Full Job Title: Senior Clinical Program Development Manager

Job Number: 1705756

Location: Tampa, FL

Date Posted: 12-1-2017

Location: Tampa, FL
Department: Health Services
Reports to: Sr. Director, Strategic Initiatives

Functions as a program development manager in collaboration with Health Services business owners or cross-functional work groups in the development and implementation of efficient and effective standards, policy and procedures, workflows, and decision support systems to support ongoing improvements of clinical and administrative operations. Works independently on program and department level interdisciplinary plans and oversees collaborative effort with external stakeholders.

Essential Functions:
  • Independently oversees the creation and implementation for programs relevant to the organization's strategic initiatives involving Health Services clinical, administrative, and operational input.
  • Leads the design and development phase of various programs/systems, work flows, and integration efforts in alignment with corporate, market, contractual, regulatory and quality requirements.
  • As the content and technical subject matter expert, facilitates presentation and communication to the director level and above business sponsors for key project initiatives including the development and oversight of detail work plans, setting deadlines, assigning responsibilities, and monitoring/summarizing project progress.
  • Oversees preparation of strategic analysis of potential business and/or operational opportunities in relation to new business, transition of care, and MEI targets using customized solutions.
  • Conducts a needs assessment and identification to ensure that the program team and other external stakeholders receive information in a timely manner. Leads the communication of the identified needs assessment to external stakeholders.
  • Prepares drafts and presents final work deliverable for the Health Services clinical and operational proposals in response to RFI, RFA, RFP, and other MEI, regulatory, compliance or special interest initiatives.
  • Perform other duties as assigned.
Candidate Education:
  • Required: Bachelor's Degree in a related field; or equivalent work experience Business, HC Management, or Nursing
  • Preferred: Master's Degree in a related field; including Business or Healthcare Management (MBA, MHA, MPH, MSN)
Candidate Experience:
  • Required: 7 years of experience in program development, program management, and/or project management, preferably in a healthcare environment
  • Preferred: 4 years of experience in managed care, plus utilization management, care coordination, disease management, Medicare, Medicaid, DSNP, dual eligibles, PCMH
  • Preferred: 4 years of experience in design, development and implementation of health care programs across a variety of settings including: defining the eligible population, service mix, delivery system configuration and financing; integration of behavioral, clinical, social, and community health care for members with multiple chronic conditions; working with multiple state agencies and providers to coordinate services and information transfer; conducting assessments, contractual reviews, and business plans for new lines of business or service areas, including managed long-term care, care management programs, and/or the integration of the dual eligibles; applying innovative approaches to defined populations to improve access to care and social resources; assisting members/providers through the transition to medical homes.
Candidate Skills:
  • Ability to communicate and make recommendations to upper management Oral and written communication skills to effectively communicate clearly with all levels of management
  • Demonstrated written communication skills
  • Demonstrated analytical skills
  • Demonstrated time management and priority setting skills
  • Ability to influence internal and external constituents
  • Ability to implement process improvements
  • Ability to work in a fast paced environment with changing priorities
  • Ability to work in a matrixed environment
  • Ability to lead/manage others in a matrixed environment
  • Demonstrated project management skills
Licenses and Certifications:
  • Preferred: Certified Case Manager (CCM)
  • Preferred: Certified Professional in Healthcare Quality (CPHQ)
Technical Skills:
  • Microsoft Outlook
  • Microsoft Word
  • Microsoft Excel
  • Microsoft Visio
  • Microsoft Project
*LI-JC1

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Last Updated On: 12/9/2015