• Behavioral Intake Coordinator

    WellCare Health Plans Inc. (Tampa, FL)
    …Education: * Required A High School or GED Candidate Experience: * Required 1 year of experience in member, provider or customer services with a managed care ... Provides customer service by receiving and answering incoming calls from behavioral health members, providers and others. Coordinates member requirements with behavioral health providers, clinical coordinators, behavioral case managers, other departments or… more
    WellCare Health Plans Inc. (02/26/17)
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  • Quality Improvement Project Manager

    WellCare Health Plans Inc. (Tampa, FL)
    …Dir, Strategic Initiatives Essential Functions: * Establishes and/or revises existing WellCare policies and procedures necessary for successful implementation of the ... Quality Improvement (QI) Program. * Pursues methods to ensure receipt of relevant data, as required for accurate trending of various QI work plan metrics. * Analyzes key plan metrics, such as top diagnoses, clinical procedures, and operational performance, to… more
    WellCare Health Plans Inc. (02/26/17)
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  • National Contracting Manager

    WellCare Health Plans Inc. (Tampa, FL)
    …Manages the contract life-cycle from the identification of providers including RFP process that includes multiple department and market participation, the vetting of ... unsolicited bids from prospective providers the direction of specific modeling requests associated with vetting the value of the potential contract, the negotiation of sophisticated rate and language provisions, the oversight of the specific configuration… more
    WellCare Health Plans Inc. (02/26/17)
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  • Hospital Services Specialist

    WellCare (Kapolei, HI)
    …Candidate Education: Required A Bachelor's Degree in Health Administration, Business or related field Candidate Experience: Required 2+ years of experience in the ... managed Care industry with a focus on claims operations and best practices Required Other Previous experience working directly with customers Required Other In-depth knowledge of Medicare/Medicaid process, rules, regulations and procedures. Candidate Skills:… more
    disABLEDperson, Inc. (02/25/17)
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  • Patient Care Advocate

    WellCare (Cypress, CA)
    …between the member/family, physician and facilities/agencies. Acts as the face of WellCare in the provider community with the provider and office staff where ... their services are embedded. Advises and educates Provider practices in appropriate HEDIS measures, and HEDIS ICD-10 /CPT coding in accordance with NCQA requirements. Assesses provider performance data to identify and strategizes opportunities for provider… more
    disABLEDperson, Inc. (02/25/17)
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  • Finance Systems Manager

    WellCare (Tampa, FL)
    …* 3 - 5 years experience managing Oracle EBS systems required. * Experience with Oracle EBS and Hyperion Planning, Contributor, Analyst required * Excellent working ... knowledge of all Microsoft Office Excel, Word, Powerpoint, and Outlook * Functional working knowledge of Oracle Request Center and Discover a plus * Must be able to effectively communicate both written and verbal with all levels of management * Ability to work… more
    JOFDAV (02/25/17)
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  • QI Project Manager

    WellCare (Kapolei, HI)
    …health of the plan. Essential Functions: Establishes and/or revises existing WellCare policies and procedures necessary for successful implementation of the Quality ... Improvement (QI) Program. Pursues methods to ensure receipt of relevant data, as required for accurate trending of various QI work plan metrics. Analyzes key plan metrics, such as top diagnoses, clinical procedures, and operational performance, to enable the… more
    JOFDAV (02/25/17)
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  • Care Coordinator - Rocky Point

    WellCare (Tampa, FL)
    …liaison in corresponding and communicating with providers, vendors and WellCare contacts and/or members representative's. Produces, formats and edits correspondence ... and documents. Organizes a variety of administrative and clinical tasks and prioritizes in order of importance and impact on members and providers. Interacts with other departments including Claims, Intake, Enrollment and Member Services to resolve member and… more
    disABLEDperson, Inc. (02/25/17)
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  • Behavioral Intake Coordinator

    WellCare (Tampa, FL)
    …Candidate Education: Required A High School or GED Candidate Experience: Required 1+ year of experience in member, provider or customer services with a managed care ... organization or call center environment and/or knowledge of basic utilization management functions. Preferred Other Knowledge in medical terminology and/or experience with CPT and ICD 9 coding preferred Candidate Skills: Intermediate Knowledge of community,… more
    JOFDAV (02/25/17)
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  • Compliance Oversight Specialist

    WellCare (Cypress, CA)
    The Compliance Oversight Specialist participates in the oversight of WellCare 's and/or WellCare 's delegated vendor's corporate ethics and compliance program, and ... focused reviews, oversight and monitoring to assess compliance with WellCare 's contractual and regulatory requirements and collaborates with business owners… more
    JOFDAV (02/25/17)
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