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Corporate Functions & Operations WellCare - Operations Leadership Careers

Strategic Initiatives - Senior Director Job

Full Job Title: Sr. Director Claims Optimization

Job Number: 1804577

Location: Statewide, FL

Date Posted: 2018-06-21

Department: Operations - Payment Integrity

Reports to: VP Provider Operations

Location: 5301 Idlewild Avenue, Tampa FL 33634

The Sr Dir, Strategic Initiatives serves as a critical resource in supporting, managing and driving strategic projects and initiatives for the Division. The position will support senior management in executing business strategies.

Essential Functions:
  • Participate with other health plan departments in planning, coordinating and problem solving in regard to claims operations.
  • Direct and oversee claims activities to ensure that services comply with governmental and accrediting agency regulations.
  • Partners effectively with business partners across the enterprise and within Operations (Configuration, Training, IT, etc.) to
  • Execute on critical business objectives and priorities.
  • Directs the strategic planning process and establishes key processes.
  • Monitors and manages key deliverables of the strategic plan.
  • Builds strong cross-functional relationships with internal departments to implement business strategies.
  • Provides project management for implementation of key initiatives and driving critical projects.
  • Interacts closely with business leaders to carry out key projects and works directly with other senior leaders to drive successful completion of tactical and strategic initiatives.
  • Consults, influences and presents to senior management at various levels in and across a wide variety of functions.
  • Advises and makes recommendations to business leaders on key strategic and tactical decisions.
  • Provides support for financial, sales and operation reporting and analysis.
  • Ability to lead change and execute on business objectives through oversight and management of key stakeholders and owners.
Additional Responsibilities:
Candidate Education:
  • Required A Bachelor's Degree in a related field
  • Required or equivalent work experience
  • Preferred A Master's Degree in a related field
Candidate Experience:
  • Required 10 years of experience in developing and implementing new business strategies
  • Required 5 years of experience in working in a managed care environment
  • Required Other Strong financial and analytical background
Candidate Skills:
  • Advanced Demonstrated analytical skills
  • Advanced Demonstrated organizational skills
  • Intermediate Demonstrated leadership skills
  • Intermediate Ability to drive multiple projects
  • Intermediate Ability to work in a fast paced environment with changing priorities
  • Advanced Demonstrated project management skills
  • Advanced Other Planning skills
  • Advanced Other Consulting skills
  • Intermediate Other Ability to work both strategically and tactically to accomplish objectives
Licenses and Certifications:
A license in one of the following is required:
    Technical Skills:
    • Required Intermediate Microsoft Word Proficiency in MS Office, including Word, Excel, PowerPoint, and Outlook, required; proficiency in Project Manager and/or Access preferred
    • Required Intermediate Microsoft Excel
    • Required Intermediate Microsoft PowerPoint
    • Required Intermediate Microsoft Outlook
    • Preferred Intermediate Other Project Manager and/or Microsoft Access

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      Last Updated On: 12/9/2015