| 1. Apply (Fulltime) | 1 day ago | WellCare - Nationwide - United States -  - (view employer jobs) | | Title: ApplyLocation: Re-applytrue1302271Responsible for statutory-basis accounting & reporting, capital analysis for the HMO and insurance subsidiaries. Additionally responsible for coordination of the Company's responses to DOI examinations. Essential Functions:
Ensures accurate and timely delivery of statutory accounting & reporting to meet external requirements (at least quarterly and annually).
Delivers statutory ... | | View | Watch | Comment |
| 2. Apply (Fulltime) | 1 day ago | | WellCare - Nationwide - United States - - (view employer jobs) | | Title: ApplyLocation: Re-applytrue1302112
The Quality Improvement Project Manager supports the development and implementation of quality improvement interventions and audits and assists in resolving deficiencies that impact plan compliance to regulatory and accreditation standards. The incumbent drives key quality improvement projects requiring the ability to work effectively in a matrix environment ... | | View | Watch | Comment |
| 3. Apply (Fulltime) | 1 day ago | | WellCare - Nationwide - United States - - (view employer jobs) | | Title: ApplyLocation: Re-applytrue1300302Assists in completing activities related to various cross-functional projects in support of goals within the department.
Manages a variety of moderately complex project activities.
Drives initiatives on all phases of project management: project planning, implementation and monitoring.
Technical resource for converting complex business issues ... | | View | Watch | Comment |
| 4. Apply (Fulltime) | 1 day ago | | WellCare - Nationwide - United States - - (view employer jobs) | | Title: ApplyLocation: Re-applytrue1203872Under the leadership of the Director of Quality Improvement is responsible for the oversight and management of Accreditation initiatives, state and regulatory quality compliance, HEDIS and quality improvement initiatives for PiPs, QiPs, QIA's, delegation audits and external quality reviews . Applies medical knowledge and analytical skills to effectively ... | | View | Watch | Comment |
| 5. Apply (Fulltime) | 1 day ago | | WellCare - Nationwide - United States - - (view employer jobs) | | Title: ApplyLocation: Re-applytrue1302422The Senior Configuration Analyst is responsible for accurate and timely development of automated rules and pricing. This position will also need to help develop new business plans that will help promote technology and automation.
Essential Functions:
Builds rules within the Peradigm System, in coordination within ... | | View | Watch | Comment |
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| 6. Apply (Fulltime) | 2 days ago | | WellCare - Nationwide - United States - - (view employer jobs) | | Title: ApplyLocation: Re-applytrue1302388The VP, Field Health Services provides the vision, strategic direction, and management of the operations for the Florida market Health Services areas, which includes Utilization Management, Field and Telephonic Care Management and Quality Management. The incumbent manages the improvement of clinical and quality indicators, improving medical cost ... | | View | Watch | Comment |
| 7. Apply (Fulltime) | 2 days ago | | WellCare - Nationwide - United States - - (view employer jobs) | | Title: ApplyLocation: Re-applytrue1300768DEPARTMENT: Customer ServiceHIRING MANAGER: Manager, Customer ServicePosition provides direct management of call center associates (Non-Exempt) and/or assists in activities for the business function (or multiple functions) within the call center, internal and/or external. People management, Root Cause Analysis, Trending, and Process Improvement all can be key ... | | View | Watch | Comment |
| 8. Apply (Fulltime) | 2 days ago | | WellCare - Nationwide - United States - - (view employer jobs) | | Title: ApplyLocation: Re-applytrue1302228
Provides advanced legal assistance to in-house counsel and internal clients with primary responsibility for corporate governance and insurance regulatory matters. Works on healthcare business legal issues, government programs compliance filings (Medicare/Medicaid), transactional matters, mergers and acquisitions, corporate record keeping, employment law, contract review and general litigation.
Essential ... | | View | Watch | Comment |
| 9. Apply (Fulltime) | 2 days ago | | WellCare - Nationwide - United States - - (view employer jobs) | | Title: ApplyLocation: Re-applytrue1203754Provides oversight and monitoring of all Medicare and Medicaid commitments to ensure compliance with contractual and regulatory obligations. Creates risk based protocols to identify, audit, and remediate operational areas of risk. Oversees and monitors implementation of Medicaid and Medicare oversight practices to provide accountability for State and Federal ... | | View | Watch | Comment |
| 10. Apply (Fulltime) | 2 days ago | | WellCare - Nationwide - United States - - (view employer jobs) | | Title: ApplyLocation: Re-applytrue1302077Supports the development and implementation of quality improvement interventions and audits and assists in resolving deficiencies impacting plan compliance to regulatory and accreditation standards. Interfaces with a diverse range of clinical and administrative professionals, resolves complex issues, and performs data analytic and reporting activities.
Essential Functions:
Manages ... | | View | Watch | Comment |
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| 11. Apply (Fulltime) | 2 days ago | | WellCare - Nationwide - United States - - (view employer jobs) | | Title: ApplyLocation: Re-applytrue1302168Provides support to Department in managing, planning, and monitoring key projects from conception through implementation. Gather and analyze data to establish and maintain business policies, processes, and procedures in order to provide support to departments.
DEPARTMENT: Health Services
REPORTS TO: Sr. Director, Clinical Care Management
Essential Functions:
Manage ... | | View | Watch | Comment |
| 12. Apply (Fulltime) | 2 days ago | | WellCare - Nationwide - United States - - (view employer jobs) | | Title: ApplyLocation: Re-applytrue1302280DEPARTMENT NAME: Provider RelationsHIRING MANAGER: Sr. Director, Network Management
Manages IPA networks and Network Development Specialists by developing and maintaining network of risk-bearing IPAs. Achieves company targets through aggressive IPA primary care, specialty and ancillary provider contracting and risk contract management. Calibrates network for ... | | View | Watch | Comment |
| 13. Apply (Fulltime) | 2 days ago | | WellCare - Nationwide - United States - - (view employer jobs) | | Title: ApplyLocation: Re-applytrue1301512Oversees utilization management activities by assessing the necessity and efficiency of services through systematic monitoring of medical necessity and quality, while maximizing the appropriate level of care that correlates to the member's benefit plan.
Essential Functions:
Conducts onsite and/or telephonic reviews and assesses medical information, in ... | | View | Watch | Comment |
| 14. Apply (Fulltime) | 2 days ago | | WellCare - Nationwide - United States - - (view employer jobs) | | Title: ApplyLocation: Re-applytrue1302366
Provides administrative support to Senior Vice Presidents and his/her director reports. Performs a wide variety of complex administrative tasks requiring initiative, strong attention to detail and extensive working knowledge of the organization and programs. Work entails confidential and sensitive issues requiring a high degree of discretion.
... | | View | Watch | Comment |
| 15. Apply (Fulltime) | 2 days ago | | WellCare - Nationwide - United States - - (view employer jobs) | | Title: ApplyLocation: Re-applytrue1301797
The Director, Quality Improvement plans, develops, and directs the Quality Improvement functions, provides leadership necessary to achieve national best practice performance levels in quality improvement initiatives, ensures that the quality of healthcare services rendered meets or exceeds professionally recognized community standards, interfaces with a diverse range of clinical ... | | View | Watch | Comment |
| 16. Apply (Fulltime) | 2 days ago | | WellCare - Nationwide - United States - - (view employer jobs) | | Title: ApplyLocation: Re-applytrue1300652Responds to member and provider inquiries (phone, written or walk in) regarding all aspects of WellCare business, including claims, in a professional, timely, accurate and caring manner while consistently meeting all guidelines.
Essential Functions:
Responds to member, provider and other inquiries via telephone, correspondence or lobby walk-in while meeting ... | | View | Watch | Comment |
| 17. Apply (Fulltime) | 2 days ago | | WellCare - Nationwide - United States - - (view employer jobs) | | Title: ApplyLocation: Re-applytrue1301794Coordinates the socio economic needs and service of selected member populations across the continuum of illness. Interviews, coordinates and plans activities and behavioral routines to meet the social and medical needs of members and their families. May manages members with severe mental illness who have high ... | | View | Watch | Comment |
| 18. Apply (Fulltime) | 2 days ago | | WellCare - Nationwide - United States - - (view employer jobs) | | Title: ApplyLocation: Re-applytrue1302412Provides administration and department support for clinical care management, case and disease management and field service coordination staff. Coordinates services and performs administrative functions. Assists in completing activities related to various cross functional projects in support of departmental goals.
Essential Functions:
Responds to phones as assigned or team ... | | View | Watch | Comment |
| 19. Apply (Fulltime) | 2 days ago | | WellCare - Nationwide - United States - - (view employer jobs) | | Title: ApplyLocation: Re-applytrue1301703The Senior Business Analyst leads in the development of complex adhoc reports to enable process and trend analysis and provides recommendations for the implementation of new/revised operational and/or reporting processes. The Senior Business Analyst conducts special projects requiring a high degree of confidentiality and expert knowledge of ... | | View | Watch | Comment |
| 20. Apply (Fulltime) | 2 days ago | | WellCare - Nationwide - United States - - (view employer jobs) | | Title: ApplyLocation: Re-applytrue1302045
Prospect for and enroll eligibles in the Medicare Advantage. Meet the minimum enrollment goal of new members into the Medicare Choice Plan. Present the Medicare Advantage using approved presentation materials at both in-home and seminar settings.
This job summary and the accountabilities listed in no ... | | View | Watch | Comment |
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