JacksonRecruiter Since 2001
the smart solution for Jackson jobs

Network Performance Advisor

Company: WellCare
Location: Jackson
Posted on: October 11, 2019

Job Description:

WellCarehas an immediate opportunity for a Network Performance Advisor to join our Missippissiteam! In this role you will serve as akey point of contact and liaison between assigned strategic providers andvarious departments within WellCare, including Quality, Operations, Finance,Health Services and other shared services departments. You will also develop and execute thestrategy for your assigned providers, including building strong workingrelationship; building trust, maintaining high provider satisfaction andhelping providers improve their performance. Our ideal candidate is someone with experience in healthcare orinsurance and who has solid Network Management/Network Development, ProviderRelations, Risk and /or Value Base Contracting experience. At WellCare, we empower you to manage therelationship and provide the resources to be successful. This position offers a robust benefitspackage including over 3 weeks of paid time off, 8 holidays and 2 floatingholidays and much more! Reports to: Director, Provider Relations Department: Provider Relations Location: Jackson, MS 39211
***Must reside in AL, AR, MS or TN. Territory includes AL, AR, MS and TN***
Essential Functions:

  • Owns and manages the relationship and performance of key provider groups.
  • Influences provider behaviors to drive improvements in provider & member satisfaction, optimizing member outcomes and maximizing shared savings.
  • Drives improvement of provider performance by analyzing, interpreting and communicating financial, utilization and quality metrics.
  • Establishes and leads cross-functional communication and collaboration with internal departments to support provider performance and resolve barriers and challenges.
  • Responsible for understanding the differences between Risk and Value-Based contracting and driving improved provider performance.
  • Plans, prepares, and executes effective group meetings/discussions with proper objectives and outcome.
  • Responsible for understanding unique contract, quality, network requirements of Medicaid and Medicare.
  • Responsible for understanding HEDIS and STARS measures and partner the Quality team to drive improved provider performance.
  • Special projects as assigned or directed.
    Candidate Education:
    • Required A Bachelor's Degree in Health Care, Business, Finance or any other field
    • Required or equivalent work experience in Network Management/Network Development, Provider Relations, Risk and /or Value Base Contracting Candidate Experience:
      • Required 5 years of experience in Network Management/Network Development, Provider Relations, Risk and/or Value Base Contracting, managed care organization
      • Required 2 years of experience in Account Management or management experience
      • Required Other Candidate Skills:
        • Advanced Other Ability to establish and manage multi-disciplinary meeting approach with key provider groups
        • Advanced Other Ability to communicate and effectively influence provider's performance
        • Advanced Other Ability to operate as lead point of contact for key provider groups
        • Advanced Other Ability to build and maintain strong and long lasting partnerships with key provider groups
        • Intermediate Other Ability to manage and work under pressure
        • Advanced Other Creates and maintains meaningful & proactive communication with provider groups
        • Intermediate Other Manage Provider's experience and satisfaction with health plan
        • Advanced Other Ability to forecast, track, and monitor provider performance
        • Advanced Other Strong interpersonal skills that build rapport and trust with provider groups
        • Advanced Other Excellent cross-functional communication with internal departments (OAR, QPA, Case Management, Field Finance) Licenses and Certifications:
          A license in one of the following is required:
          Technical Skills:
          • Required Advanced Microsoft Excel
          • Required Advanced Microsoft Outlook
          • Required Advanced Microsoft Word Languages:
            About usHeadquartered in Tampa, Fla., WellCare Health Plans, Inc. (NYSE: WCG) focuses primarily on providing government-sponsored managed care services to families, children, seniors and individuals with complex medical needs primarily through Medicaid, Medicare Advantage and Medicare Prescription Drug Plans, as well as individuals in the Health Insurance Marketplace. WellCare serves approximately 5.5 million members nationwide as of September 30, 2018. WellCare is a Fortune 500 company that employs nearly 12,000 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, creed, age, sex, pregnancy, veteran status, marital status, sexual orientation, gender identity or expression, national origin, ancestry, disability, genetic information, childbirth or related medical condition or other legally protected basis protected by applicable federal or state law except where a bona fide occupational qualification applies. Comprehensive Health Management, Inc. is an equal opportunity employer, M/F/D/V/SO.

Keywords: WellCare, Jackson , Network Performance Advisor, Other , Jackson, Mississippi

Click here to apply!

Didn't find what you're looking for? Search again!

I'm looking for
in category
within


Other Other Jobs


Work From Home/F/T - P/T/No More Time Clocks!!
Description: Are you tired of getting up early, grabbing your coffee, heading for the traffic and rushing to the time clock Are you not wanting to miss special times with your family which, when lost, will never (more...)
Company: Health Inc.
Location: Jackson
Posted on: 10/25/2019

Dentist
Description: A dentistry clinic in Mississippi is looking for a dentist to provide locum
Company: Barton Associates
Location: Jackson
Posted on: 10/25/2019

Player's Pass Regional Partner
Description: Players Pass is looking for a Regional Partner in Mississippi. Are you an avid golfer Strong experienced sales
Company: Players Pass
Location: Jackson
Posted on: 10/25/2019


Remote English Teacher
Description: Work-from-Home Online Teaching Opportunity Control your days, work remotely, AND change lives Teach English online to kids in China ages 6 to 10 with EF Education First, the world's largest private (more...)
Company: Education First
Location: Hattiesburg
Posted on: 10/25/2019

Driver - Team Truck Driver - Class A CDL
Description: bonus driver trucks trucking Team truck drivers are among the highest compensated in Schneider's fleet. Team driving jobs in our Van Truckload Division feature a predictable work schedule, up to 0.53 (more...)
Company: Schneider
Location: Hattiesburg
Posted on: 10/25/2019

Class A OTR Truck Driver - Hattiesburg
Description: Job Description: Midwest / Southeast LanesHome Weekend - Some Areas MoreRevised Competitive PayDry Van - No
Company: Venture Logistics
Location: Hattiesburg
Posted on: 10/25/2019

Truck Driver - Owner-Operator Truck Driver - Owner-Operator
Description: bonus owner operator driver trucks trucking Make up to 175,000 in potential annual revenue by choosing what freight you haul with Schneider's Van Choice program. owner-operators truck drivers can select (more...)
Company: Schneider
Location: Jackson
Posted on: 10/25/2019

Driver - Jet-Set Intermodal Truck Driver - Class A CDL
Description: bonus driver trucks trucking Jet-Set Intermodal truck drivers get a paid flight from their home location to various locations across the country to haul freight, then get a paid flight back for home (more...)
Company: Schneider
Location: Jackson
Posted on: 10/25/2019

Driver - Dedicated Team Truck Driver - Class A CDL
Description: bonus driver trucks trucking This Dedicated Team truck driver position earns up to 0.49 per mile with a weekly performance pay up to 0.04 per mile and offers home time every three weeks. Dedicated (more...)
Company: Schneider
Location: Jackson
Posted on: 10/25/2019

Driver - Over-the-Road (OTR) Truck Driver - Class A CDL
Description: bonus driver trucks trucking Over-the-Road truck drivers earn up to 0.48 per mile starting pay with a weekly performance pay up to 0.04 per mile and choose from different home time options in this (more...)
Company: Schneider
Location: Hattiesburg
Posted on: 10/25/2019

Log In or Create An Account

Get the latest Mississippi jobs by following @recnetMS on Twitter!

Jackson RSS job feeds