Full Job Description
"At WellCare, we are a passionate team with a strong mission and a focused purpose: to serve our members and communities in which they live while helping them live better, healthier lives. Our culture is one of empowerment, teamwork and commitment as we all work together to deliver cost-effective solutions that create positive outcomes for our members. Join us a career that inspires passion and purpose across all levels and disciplines within our award-winning organization."
Reporting to: Mgr, CHS Quality Program Dev
Department: UAM-ACO-Case Management
Provides administration and department support for care management and clinical teams. Coordinates services and performs administrative functions. Assists in completing activities related to various cross functional projects in support of departmental goals.
Responds to phones as assigned or team coverage as directed by Supervisor.
Provides technical and administrative support to clinical and behavioral staff as needed.
Assists, completes and submits special projects, reports or assignments to meet department needs and objectives.
Serves as a 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 provider issues.
Participates and supports tasks, including but not limited to: faxes, discharge preparations, request and/or collection of clinical information, engaging/contacting providers and creation of authorizations if necessary.
Performs other duties as assigned.
Required A High School or GED
Preferred An Associate's Degree in a related field
Required 3 years of experience in a managed care setting, medical office or facility setting with demonstration of medical administration duties
Required Other In Behavioral Health, 3 years in performing administrative and/or clinical responsibilities in a medical, behavioral, or non-medical setting with demonstration of administrative duties (clerical, admin asst)
Intermediate Ability to analyze and interpret financial data in order to coordinate the preparation of financial records
Intermediate Demonstrated interpersonal/verbal communication skills
Intermediate Demonstrated written communication skills
Intermediate Ability to effectively present information and respond to questions from peers and management
Intermediate Ability to multi-task
Intermediate Other Work effectively within group to achieve desired outcomes
Licenses and Certifications:A license in one of the following is required:
Required Intermediate Microsoft Outlook
Required Intermediate Microsoft Excel
Required Intermediate Microsoft Word
Headquartered 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.