• WellCare Health Plans Inc. (Arlington, VA)
    …and implements best practices for key stakeholders to mitigate risk to WellCare . * Proactively evaluates the government reimbursement process to determine areas of ... risk and opportunity and provide senior management with necessary updates and/or strategic recommendations. * Provides ad-hoc analysis for senior management. * Manages and develops cross functional teams, including direct reports who include other management… more
    WellCare Health Plans Inc. (10/15/17)
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  • Wellcare Internal (Tampa, FL)
    …Candidate Education: * Required A Bachelor's Degree in a related field finance / business * Required or equivalent work experience 2 years of experience in a finance ... or business related position Candidate Experience: * Preferred Other finance or business environment Candidate Skills: * Beginner Ability to analyze and interpret financial data in order to coordinate the preparation of financial records * Beginner Ability to… more
    Wellcare Internal (10/22/17)
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  • WellCare Health Plans Inc. (Tampa, FL)
    …reviews on associate calls, enrollment files and/or casework in accordance with WellCare 's quality policy * Review casework (CTM, Grievance) and call documentation ... accuracy of information while meeting compliance turn-around-times in accordance with WellCare Policy and Procedure and any government (Federal or State) processes… more
    WellCare Health Plans Inc. (10/22/17)
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  • Wellcare Internal (St. Louis, MO)
    …* Case load may differ by state and/or location based on contract requirements, membership, plan and/or operational best practice * Some states and/or locations may ... require nurses to occasionally travel to facility or inpatient bedside to conduct assessments or face to face visits * Some state/market care managers may be responsible for Utilization Management and uses prescribed criteria to provide timely, appropriate,… more
    Wellcare Internal (10/22/17)
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  • WellCare Health Plans Inc. (Manhattan, NY)
    …Candidate Education: * Required A Bachelor's Degree in Nursing or Health Administration * Required or equivalent work experience In Nursing in a clinical setting ... Manages the activities of supervisory associates and their subordinate work group(s) and/or exempt individual contributors for assigned area of responsibility. Works with the Supervisor(s) and Case Managers to assess, plan, implement, coordinate, monitor, and… more
    WellCare Health Plans Inc. (10/22/17)
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  • WellCare Health Plans Inc. (Newark, NJ)
    …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. (10/22/17)
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  • Wellcare Internal (Kapolei, HI)
    …Candidate Education: * Required A High School or GED Candidate Experience: * Required 2 years of experience in an acute clinical/surgical position(s), current ... experience in utilization management to include pre-authorization, utilization review, concurrent review, discharge planning, and/or skilled nursing facility reviews * Preferred Other Care management experience in a managed health care setting Candidate… more
    Wellcare Internal (10/22/17)
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  • WellCare Health Plans Inc. (Tampa, FL)
    …* Case load may differ by state and/or location based on contract requirements, membership, plan and/or operational best practice. * Some states and/or locations may ... require nurses to occasionally travel to facility or inpatient bedside to conduct assessments or face to face visits. Candidate Education: * Required An Associate's Degree in nursing or graduation from Diploma Nursing School * Preferred A Bachelor's Degree in… more
    WellCare Health Plans Inc. (10/22/17)
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  • Wellcare Health Plans, Inc (Tampa, FL)
    …Transfer knowledge to other members of the Shared Applications team Review new technologies against business requirements to identify opportunities for improvements ... and to identify opportunities to reduce costs Candidate Education: Preferred A Bachelor's Degree in Information Systems, Information Technology or related field Candidate Experience: Required 3 years of experience in Working to administer, configure or… more
    Careerbliss (10/22/17)
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  • WellCare Health Plans Inc. (Alamogordo, NM)
    …position is contingent upon the bid award in the state of New Mexico to WellCare Health Plans, Inc. Candidate Education: * A Bachelor's Degree in a related field or ... equivalent work experience directly related to the level and duties of the job required. Candidate Experience: * 7 years of experience in provider relations or similar background required. * 4 years of experience in management required. Candidate Skills: *… more
    WellCare Health Plans Inc. (10/21/17)
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  • Wellcare Health Plans, Inc. (Richmond, NY)
    This link will leave wellcare .com, opening in a new window. WellCare and its subsidiaries are not responsible for non- WellCare content, privacy practices, ... organizations to ensure that the health care needs of WellCare members are met. Provides strategic design and implementation...the bid award in the state of Virginia to WellCare Health Plans, Inc. Candidate Education: Required A Bachelor's… more
    Wellcare Health Plans, Inc. (10/21/17)
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  • WellCare Health Plans Inc. (Tampa, FL)
    …Participate as a liaison with regional market operations. Provide analytics for strategic and operating decisions to senior management. Provide proactive analysis and ... recommendations to senior management on both tactical and strategic nature. DEPARTMENT: Financial Analytics REPORTS TO: Senior Manager of Medical Economics Essential Functions: * Proactive involvement with identification, evaluation and monitoring of medical… more
    WellCare Health Plans Inc. (10/21/17)
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  • WellCare Health Plans Inc. (Brentwood, TN)
    …Reports to: Dir. Utilization Management Department: Health Services-NE Location: Untied States Essential Functions: * Supervises a staff of nurses to achieve ... successful quality outcomes and benefit maximization towards members care. * Supervises processes and procedures to ensure compliance with contractual, regulatory (Federal/State) and accreditation entities. * Provides leadership and support to front-line… more
    WellCare Health Plans Inc. (10/21/17)
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  • Wellcare Internal (Buffalo, NY)
    …* Reviews and quality checks enrollment paperwork before processing. * When needed, assists in the creation of materials such as flyers, pamphlets, event material ... etc. * May be asked to support and travel to other territories from time to time. * Conducts new member orientations. * Contacts approved leads by telephone to set appointments. * Required to use personal transportation for appointment with prospective members… more
    Wellcare Internal (10/21/17)
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  • WellCare Health Plans Inc. (Tampa, FL)
    …Candidate Education: * Required A High School or GED Candidate Experience: * Required 1 year of experience in Analytical Role * Preferred 1 year of experience in ... To ensure accurate and timely loading of a provider contract, maintenance and termination processes through appropriate research. Essential Functions: * Loads professional contracts into the Diamond System through appropriate research and provider data load… more
    WellCare Health Plans Inc. (10/21/17)
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  • WellCare Health Plans Inc. (Manhattan, NY)
    …(institutional) and provider groups maximizing their ability to interact with WellCare . Manages education and issues related to claims, reimbursement, authorizations ... supplements and supports as necessary. * Partners internally with information exchange when WellCare has failed on service. * Conduit for provider issues that cross… more
    WellCare Health Plans Inc. (10/21/17)
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  • WellCare Health Plans Inc. (Tampa, FL)
    …* Review new technologies against business requirements to identify opportunities for improvements and to identify opportunities to reduce costs. Candidate Education: ... Implements, maintains, administers and supports a third-party application used in conjunction with business and IT critical systems. Completes assigned work to a third party application through configuration and/or coding. This position requires subject matter… more
    WellCare Health Plans Inc. (10/21/17)
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  • WellCare Health Plans Inc. (Tampa, FL)
    …or health insurance * Required Other or 9 months to 1 year experience at WellCare as a Sr CSR or Sr. Claims Specialist. Candidate Skills: * Intermediate Demonstrated ... written communication skills * Intermediate Demonstrated interpersonal/verbal communication skills * Intermediate Ability to work as part of a team * Intermediate Ability to effectively present information and respond to questions from peers and management *… more
    WellCare Health Plans Inc. (10/21/17)
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  • WellCare Health Plans Inc. (Fort Myers, FL)
    …* Responds to member, provider and other inquiries on-site for walk-in requests while meeting all corporate guidelines and performance standards. * Records, ... investigates and resolves member complaints as detailed in the Grievance Procedure narrative. * Supports field office member, provider and staff events, coordinates materials and invitations, and plans and orders food where necessary. * Occasional work during… more
    WellCare Health Plans Inc. (10/21/17)
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  • WellCare Health Plans Inc. (Tampa, FL)
    …Experience: * Required Other Internal candidates: 18 months of experience with WellCare in a related field * Required Other External candidates: An associates ... degree plus 1 year in a related field or 3 years experience in a related field without an associates degree Candidate Skills: * Intermediate Ability to effectively present information and respond to questions from peers and management Critical thinker *… more
    WellCare Health Plans Inc. (10/21/17)
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