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Product Operations Specialist - Tampa, Florida

Company: Wellcare Health Plans
Location: Tampa
Posted on: September 15, 2019

Job Description:

This position supports the implementation and/or drives the ongoing operational maintenance of assigned product(s) or service area(s) through communication and solid relationship management with internal and external stakeholders, identifying opportunities for integrated process improvement, escalating issues as necessary, and supporting the success of the product. Creates and maintains reporting tools to effectively analyze and develop process improvement opportunities that enhance the operational effectiveness of the product(s) or service area(s).Essential Functions: Serves as the subject matter expert (SME) for the assigned product(s) or service area(s). Drives assigned operational aspects of the product(s)/service(s). Assesses operational performance and escalations by tracking, analyzing and researching performance level expectations. Monitors assigned internal/external relationships to ensure compliance with contractual requirements. Develops effective relationships with key partners and stakeholders to influence and drive operational enhancements. Proactively identifies trends and root cause analysis to drive resolution of complex escalations; including communications and reporting. Creates reports and supports business review presentations to key stakeholders; including, but not limited to, Senior Leadership Team, Vendors and/or Government agencies. Participates in and supports department and/or product strategic planning activities. Manages projects including the implementations for delegated functions as needed. Collaborates with internal and/or external partners to execute assigned business objectives and initiatives. Ensures member or other stakeholder communications contain appropriate information, talking points and FAQs, and are effectively implemented. Performs other duties as assigned. Additional Responsibilities:Candidate Education: Required A Bachelor's Degree in business administration / related field Required or equivalent work experience Candidate Experience: Required 2 years of experience in Leading or supporting projects in the following areas: Benefits, Product Management, Marketing and Sales, Strategic Planning, and/or Project Management-OR-Data analysis and process improvement in the following areas: Benefits, Healthcare or Regulatory/Government Affairs-OR-Vendor management or oversight; preferably with healthcare vendors Required 2 years of experience in customer service experience in a healthcare contact center or customer service environment dealing with claims, grievances pharmacy and appeals authorizations in one or more of the following: Medicare, Medicaid, PDP, Exchange etc. Preferred Other Experience in health care or managed care environment Preferred Other Experience working the state reporting, regulatory/government affairs Candidate Skills: Intermediate Demonstrated interpersonal/verbal communication skills Intermediate Ability to influence internal and external constituents Intermediate Demonstrated negotiation skills Intermediate Demonstrated written communication skills Intermediate Ability to work independently Intermediate Ability to work in a fast paced environment with changing priorities Intermediate Demonstrated organizational skills Intermediate Ability to effectively present information and respond to questions from peers and management Intermediate Ability to analyze information and convert related activities into a comprehensive work plan Intermediate Ability to communicate and make recommendations to upper management Licenses and Certifications:A license in one of the following is required:Technical Skills: Required Intermediate Microsoft Outlook Required Intermediate Microsoft Word Required Intermediate Microsoft PowerPoint Required Advanced Microsoft Excel Languages:About usHeadquartered in Tampa, Fla., WellCare Health Plans, Inc. (NYSE: WCG) focuses exclusively on providing government-sponsored managed care services through Medicaid, Medicare Advantage and Medicare Prescription Drug Plans to families, children, seniors and individuals with complex medical needs. The company serves approximately 4.4 million members nationwide as of Dec. 31, 2017. WellCare is a Fortune 500 company that employs nearly 9,000 associates across the country and was ranked a ''World's Most Admired Company'' in 2018 by Fortune magazine. For more information about WellCare, please visit the company's website at www.wellcare.com. 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.

Keywords: Wellcare Health Plans, Tampa , Product Operations Specialist - Tampa, Florida, Other , Tampa, Florida

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