Manager, Claims
WellCare - Tampa, FL

This job posting is no longer available on WellCare. Find similar jobs: Manager jobs - WellCare jobs

-

1300585

About WellCare: WellCare Health Plans, Inc. provides managed care services targeted to government-sponsored health care programs, focusing on Medicaid and Medicare. Headquartered in Tampa, Florida, WellCare offers a variety of health plans for families, children, and the aged, blind, and disabled, as well as prescription drug plans. For more information about WellCare, please visit the Company's website at www.wellcare.com.

Our History: Founded in 1985 with three associates, WellCare grew to more than 800 associates and 467,000 members in Florida, New York and Connecticut by 2002. In 2004, the company acquired Harmony to enter the Midwest and became publicly traded. By 2006, WellCare served 2.2 million members as it became a national prescription drug plan provider and the largest Medicaid plan in Georgia. WellCare expanded its services when it began offering Medicaid managed care plans in Ohio and Missouri in 2007, and Medicare managed care plans in Texas and New Jersey in 2008. Additional growth followed when the company was chosen to serve Hawaii's Medicaid program for the aged, blind or disabled in 2009, and in 2011 when it was selected to serve Kentucky's Medicaid program. Today, WellCare has more than 3,900 associates and approximately 2.4 million members nationwide.

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.

Description

Manages the activities of Team Lead associates and their subordinate work group(s) and/or exempt individual contributors for claims unit. Assignments are somewhat broad in nature, often requiring originality and ingenuity. Responsible for all performance results of unit.

Essential Functions:
Manages and develops direct reports who include Team Leaders and front-line associates. Directs work assignments, measures results and initiates personnel actions as required for assigned claims unit

Manages process improvement initiatives, seeking root cause and developing appropriate corrective action

Establishes objectives, schedules, and cost data for the business of the function being managed

Coordinates activities of unit to meet budget and deadlines and resolves conflicting demands

Applies a comprehensive knowledge of claims and provider contracts to the completion of assignments. Has knowledge of all products and all types of claims

Serves as primary contact for complex issues

Assists in developing short range plans for overall area activities

May oversee the implementation of programs and strategies

May act in liaison capacity with other areas and business units

May make recommendations on matters of policy and approve changes in area of expertise.

Qualifications

Education:
High school diploma or GED required; College degree preferred

Experience:
5+ years of progressively responsible directly related experience in claims

Technical Skills/Requirements:
Strong communication skills

Knowledge of Microsoft Office, including Outlook, Word and/or Excel

Primary Location

FL-Tampa

Is a relocation package available?

No

WellCare - 20 months ago - save job - copy to clipboard - block
Recommended Jobs
Brokerage Service Representative
Jackson National Life Insurance Company - Tampa, FL
Jackson National Life Insurance Company - 1 hour ago

Fiscal & Business Assistant - PCard
University of South Florida - Tampa, FL
University of South Florida - 5 days ago

DME Bill Auditor - Tampa, FL
Helios, (formerly PMSI/Progressive Medical) - Tampa, FL
Indeed - 15 days ago
Easily apply
About this company
86 reviews
WellCare knows that to get well, all you need is a little care. WellCare Health Plans provides managed-care administrative services to...