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Wellcare

Chief Operating Officer - Georgia

Wellcare - Atlanta, GA

Chief Operating Officer - Georgia','1800249','!*!About WellCare: WellCare Health Plans, Inc. is a Fortune 500 company traded on the New York Stock Exchange (symbol: WCG). It provides managed care services targeted to government-sponsored health care programs, including Medicaid, Medicare, Prescription Drug Plans and the Health Insurance Marketplace. Headquartered in Tampa, Fla., WellCare offers a variety of health plans for families, children, and the aged, blind and disabled. The company serves approximately 4 million members and employs approximately 6,500 people nationwide as of Sept. 30, 2014. For more information about WellCare, please visit our website at www.wellcare.com or view our videos at https://www.youtube.com/user/WellCareHealthPlan.EOE: All qualified applicants shall receive consideration for employment without regard to race, color, religion, sex, age forty (40) and over, disability, veteran status, or national origin.','!*!Responsible for the overall operations of the health plan, including strategic direction, administration for all existing programs and the development of new programs to ensure goals and objectives are met or exceeded. Working closely with WellCare's executive leadership team, leads and directs the overall improvement of operations including:  provider contracting and relations, sales and marketing, medical management, regulatory compliance and finance, as well as interfacing with corporate office operations.  Serves as the representative of the health plan to government entities and other external agencies and ensures compliance with all relevant regulatory agencies.

Reports to: State President

Dept.: Executive Administration - GA

Location: Atlanta, GA

Essential Functions:

Leads and directs the day to day operations of the health plan.  This includes providing leadership and direction to the management team to ensure the organization's strategic plan is translated into tactical goals and objectives that guarantee performance objectives are met or exceeded.

Directs and manages the organization's financial performance.  Takes appropriate actions to increase revenue, leverage resources, manages and/or minimizes expenses and ensure compliance with all business and administrative regulations.

Directs the development of annual budgets and presents the budgets for approval.

Assist and leads where appropriate, with aspects of state and federal government relationships, including dealing with regulators, as necessary, to establish and continue effective working relationships.  Ensures that all state and federal regulations are met.

Oversees the development and maintenance of a viable provider network to ensure the health care needs of WellCare members.  Develops and manages provider contracts and partnerships to achieve quality and cost management objectives.  Works closely with providers to enhance relationships and maximize their ability to effectively manage the cost of medical delivery.

Oversees the development, implementation and continuous evaluation of the utilization and quality management program for medical services delivered by contracted health care providers.

Oversees the development and implementation of short and long term sales and marketing plans.

Leads organizational development activities that develop and foster strong working relationships among the members of the management team.  Builds and promotes the culture of the plan to be consistent with the values established by the corporate office.

Establishes formal and informal mechanisms to promote and maintain credibility, competence, and a positive corporate image by exhibiting strong communication to the corporate office, providers, members and committees.

Develops and implements key components of business strategy 

Develops new models and processes to meet future business needs

Sets company priorities

Establishes reporting systems and controls to ensure compliance with company requirements

Recommends, develops, and aligns policies and procedures with company objectives

Provides problem analysis and problem resolution at both a strategic and functional level

Recommends and leads improvement processes and initiatives','!*!Education/Experience: 

Bachelor's degree in business administration, finance or a related field, with a master's degree strongly preferred

Successful track record in:  Provider Relations, ownership of top and bottom line P&L responsibility with a successful HMO (government program experience preferred), growing membership and revenue, and improving the MLR

Extensive experience in provider contracting

Minimum of five to seven years of senior management experience with P&L accountability for a managed care organization

Broad knowledge of the managed care industry and proven experience leading governmental programs.

Comprehensive knowledge of delivery system operations, provider contracting, strategic planning and overall service delivery

Powerful leadership skills with a vision and understanding of the future and subsequent changes required to meet business needs

Sales background preferred with ability to motivate a sales force

Ability to retain confidentiality regarding privileged company information

Provides proactive approach and support to emerging business activities established to remain competitive in the marketplace

Proven ability to affect change and meet business goals, monitor progress and take corrective actions when necessary

Computer Skills:

Knowledge of Microsoft Office including Word, Excel, Outlook Express 

Knowledge of and/or ability to utilize COGNOS for budgetary decisions or review.

Other:

An extremely organized, disciplined, hands on and process oriented leader who is not afraid of digging into details when necessary

A failure is not an option mentality and demonstrated proactive management style.

Strong business acumen, intelligence, and capacity.  Thinks strategically and implements tactically.

Problem solves and approaches work from a return on investment perspective.

Able to work in a matrixed reporting environment

Ability to work in a high energy, fast paced and data driven environment

Highly Flexible regarding schedules, priority shifts

Ability to think creatively and out of the box.

Ability to remain calm under pressure.

 

#LI-ML1','US-GA-Atlanta','211 Perimeter Ctr Parkway','Suite 800','Atlanta','30346','','','No','No','Chief Operating Officer - Georgia'

6 days 4 hours ago

Wellcare

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Chief Operating Officer - Georgia Wellcare - Atlanta, GA, United States

   

Location: Atlanta, GA

Company Profile:
WellCare Health Plans, Inc. focuses exclusively on providing government-sponsored managed care services, primarily through Medicaid, Medicare Advantage and Medicare Prescription Drug Plans, to families, children, seniors and individuals with complex medical needs. The company served approximately 3.8 million members nationwide as of Sept. 30, 2015. For more information about WellCare, please review our website and view the company’s videos. WellCare has developed a full complement of expertise in three major areas of government-sponsored health care…. Medicaid, Medicare Advantage and Medicare Prescription Drug Plans. Leveraging our expertise for our members' benefit is a key part of the value we bring to our members. WellCare focuses on those members who are dually eligible for both Medicaid and Medicare. This is an area of specialization that many other health plans simply do not have. We are committed to continually improving the quality of care and service that we provide to our members. We help our members access the right care at the right time in the appropriate setting. For some members, this includes the use of coordinated care teams and community partnerships. And we’re focused on government customers and use a disciplined approach to ensure a competitive cost structure.