• WellCare Health Plans Inc (Tampa, FL)
    …Party Liability (TPL) / Coordination of Benefits (COB) instances for WellCare membership.Validates primary insurance coverage for claims received by WellCare ... in SalesForce.Verifies Medicaid eligibility for any paper applications received by WellCare .Assists in the validation of continued DSNP eligibility for all current… more
    Lensa (07/30/17)
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  • WellCare (Tampa, FL)
    …of other insurance coverage. Additionally, provides outreach screening services for WellCare Medicare members who are potentially eligible for benefits through the ... Third Party Liability (TPL) / Coordination of Benefits (COB) instances for WellCare membership. Validates primary insurance coverage for claims received by … more
    Lensa (07/30/17)
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  • Manager, Medicare Sales

    WellCare Health Plans Inc. (Augusta, GA)
    …for accuracy. * Provides guidance to more junior associates based on WellCare 's best practice to improve performance and effectiveness. * Strictly adheres to ... the CMS and WellCare 's Marketing MIPPA regulations. * Performs other duties as...Position requires daily use of considerable discretion and judgment #LI- Wellcare Education/Experience: * High School Diploma. An Associate's or… more
    WellCare Health Plans Inc. (08/17/17)
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  • *District Sales Manager-Medicare Tampa License…

    WellCare Health Plans Inc. (Tampa, FL)
    …retention and marketing of PDP/CCP lines of business. Essential Functions: * Delivers WellCare 's Value Proposition to the broker team in assigned market. * Drives ... broker team to maximize new membership enrollment. * Staffs, trains, evaluates and develops broker sales force in assigned territory. * Works collaboratively across functional areas by serving as a resource within one's region and by leveraging the expertise… more
    WellCare Health Plans Inc. (08/17/17)
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  • Community Health Worker

    WellCare Health Plans Inc. (New Port Richey, FL)
    …Education: * Required A High School or GED Candidate Experience: * Preferred 2 years of experience in health or social services Candidate Skills: * Intermediate ... Ability to effectively present information and respond to questions from families, members, and providers * Intermediate Ability to work independently * Intermediate Demonstrated interpersonal/verbal communication skills Licenses and Certifications: * Required… more
    WellCare Health Plans Inc. (08/17/17)
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  • Strategic Initiatives - Senior Director

    WellCare Health Plans Inc. (Tampa, FL)
    …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 ... 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. Reports to: EVP, Medicare and… more
    WellCare Health Plans Inc. (08/17/17)
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  • Data Reconciliation Spec, Sr

    Wellcare Internal (Tampa, FL)
    …Candidate Education: * Required A High School or GED Candidate Experience: * Required 2 years of experience in Claims processing or general health care background. ... Department: Operations Reports to: Operations Supervisor Location: 5301 Idlewild Ave Tampa FL 33634 Level: Seven (non-exempt - Hourly) Primary responsibility is to identify root cause of our Provider Check Tracer and Check Return inquiries and partner with all… more
    Wellcare Internal (08/17/17)
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  • Corporate Counsel Litigation

    WellCare Health Plans Inc. (Tampa, FL)
    …REPORTING TO: VP Asst General Counsel Headquartered in Tampa, Fla., WellCare Health Plans, Inc. (NYSE: WCG) focuses exclusively on providing government-sponsored ... Plans, to families, children, seniors and individuals with complex medical needs. WellCare serves approximately 4 million members nationally. WellCare is seeking… more
    WellCare Health Plans Inc. (08/17/17)
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  • Vendor Services Account Manager

    WellCare Health Plans Inc. (Atlanta, GA)
    …Operations Position Location: Atlanta, GA 30346 Essential Functions: * Interfaces with WellCare associates and vendors to identify strategies to meet state and ... federal contractual requirements * Independently manages project plans through execution * Chairs monthly cross functional JOC meetings with vendors, markets and internal parties to review vendor performance and vendor projects with follow up on action times… more
    WellCare Health Plans Inc. (08/17/17)
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  • Quality Improvement Project Manager

    WellCare Health Plans Inc. (Columbia, SC)
    …Columbia, SC 29210 Essential Functions: * Establishes and/or revises existing WellCare policies and procedures necessary for successful implementation of the Quality ... matters of policy in area of expertise. * Performs other duties as assigned. #LI- WellCare Candidate Education: * Required A Bachelor's Degree in nursing or a related… more
    WellCare Health Plans Inc. (08/17/17)
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  • Account Relations Manager

    WellCare Health Plans Inc. (Tampa, FL)
    …as required. Acts as the critical link between our vendor partners and WellCare . As the company's operations representative, this position manages the facilitation ... from initial launch of services through day to day interactions. Process and project management are key aspects of this position. Essential Functions: * Offers program support for various LOBs to Site Leadership * Works with the Business Intelligence,… more
    WellCare Health Plans Inc. (08/17/17)
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  • Director, Strategic Market Analysis (Encounters,…

    WellCare Health Plans Inc. (Richmond, VA)
    …Leads the development of complex reporting and analysis, aimed at identifying root cause and trend identification which can be translated into actionable ROI for the ... Incumbent is responsible for providing market-embedded thought leadership, competitive financial analysis and statistical studies for areas with considerable potential ROI, which may include: market encounter data, Medicaid risk adjustment optimization, member… more
    WellCare Health Plans Inc. (08/17/17)
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  • Paralegal - Litigation & Regulatory

    WellCare Health Plans Inc. (Tampa, FL)
    …TO: VP, Litigation, Regulatory & Operations Headquartered in Tampa, Fla., WellCare Health Plans, Inc. (NYSE: WCG) focuses exclusively on providing ... Plans, to families, children, seniors and individuals with complex medical needs. WellCare serves approximately 4 million members nationally. WellCare is seeking… more
    WellCare Health Plans Inc. (08/17/17)
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  • Business Technical Analyst

    WellCare Health Plans Inc. (Louisville, KY)
    …Acts as subject matter expert for department or business unit on business systems/applications. Analyzes company functions, processes, and activities to improve ... computer-based business applications for the most effective use of money, materials, equipment, and people. Performs application/system design and implementation. Documents development requirements. Consults with end users to test and debug applications to… more
    WellCare Health Plans Inc. (08/17/17)
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  • Operations Lead

    WellCare Health Plans Inc. (Tampa, FL)
    …and escalations (phone, written, or walk in) regarding all aspects of WellCare business within Operations in a professional, timely, accurate manner while ... issues in which special care is required to enhance WellCare relationships with members and providers. * Acts as...resolve member and provider problems. * Drives and supports WellCare initiatives at the team by interacting with peers… more
    WellCare Health Plans Inc. (08/17/17)
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  • Case Manager - RN

    WellCare Health Plans Inc. (Chicago, IL)
    …or inpatient bedside to conduct assessments or face to face visits. * LI- Wellcare Candidate Education: * Required an Associate's Degree in nursing or graduation from ... Diploma Nursing School * Preferred a Bachelor's Degree in nursing or related field Candidate Experience: * Required 2 years of experience in a clinical acute care position(s), preferably in home health, physicians office or public health * Preferred 1 year of… more
    WellCare Health Plans Inc. (08/17/17)
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  • Software Engineer - Associate

    WellCare Health Plans Inc. (Tampa, FL)
    …with customers and colleagues to meet expected service levels. * Maintains WellCare Information Systems (IS) development standards and best practices. * Completes ... time estimates for assigned tasks * Assists in writing on-line help manuals, user manuals and FAQs for specific software projects. * Effectively convey updates and project status to peers and management. * Performs other duties as assigned. Additional… more
    WellCare Health Plans Inc. (08/17/17)
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  • Quality Improvement Specialist

    WellCare Health Plans Inc. (Tampa, FL)
    …* Completes Licensed Health Care Risk Management certification program. * Performs annual update on Plan Risk Management Program Description. * Coordinates the ... Dept QI Reports to Dir QI Location Rocky Point Supports the development and implementation of quality improvement interventions and audits and assists in resolving deficiencies impacting plan compliance to regulatory and accreditation standards. Interfaces… more
    WellCare Health Plans Inc. (08/17/17)
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  • SIU Investigator - Senior

    WellCare Health Plans Inc. (Louisville, KY)
    …Education: * Required A Bachelor's Degree in a related field or equivalent combination of education and experience required Candidate Experience: * Required 5 years ... of experience in Investigations and healthcare fraud-related investigations combined * Medical investigative experience with a focus on Medicaid and Medicare Preferred. Candidate Skills: * Advanced Knowledge of community, state and federal laws and resources *… more
    WellCare Health Plans Inc. (08/17/17)
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  • State COO, Virginia

    Wellcare Internal (Richmond, VA)
    …ensure goals and objectives are met or exceeded. Working closely with WellCare 's executive leadership team, leads and directs the overall improvement of operations ... 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… more
    Wellcare Internal (08/17/17)
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