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Director, State Regulatory Affairs- Waipahu, Hawaii Job Details

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Company:  WellCare Health Plans, Inc.
Job Code:  1103527
Categories:  For-Profit Senior Services
Job Role:  Maintenance / Facilities Mgmt / Building & Grounds
Region/Province:  Hawaii (HA)
City:  HI-Oahu-Honolulu
Job Description:  !*!WellCare Health Plans, Inc. (NYSE: WCG) provides managed care services exclusively for government-sponsored health care programs, focusing on Medicare and Medicaid. A 2008 Fortune 500 Company headquartered in Tampa, Florida, WellCare offers a variety of health plans for families, children and the aged, blind and disabled, as well as prescription drug plans. The Company employs approximately 3,800 associates and services nearly 2.4 million members nationwide as of June 30, 2009.

At WellCare, we strive to be the leader in government-sponsored health care programs. Our actions must consistently demonstrate a high level of integrity that earns the trust of those we serve, and all of our associates must be responsible for the commitments we make and the results we deliver. To accomplish this, we must hire and develop the best possible talent, and create a fulfilling environment for our associates where diversity is valued, achievements are recognized and people of all backgrounds and talents are encouraged to grow.
 

Leads the State Regulatory Affairs department responsible for developing and executing the  Medicaid Regulatory Affairs strategy focused on publicly funded healthcare programs.  Provides guidance, oversight and support to Regulatory Affairs teams with respect to contract administration and account management.

 

Essential Functions:


  • Identifies, compiles and aggregates regulatory and operational issues across markets to manage risk.  Partners with markets on resolutions through expertise and lessons learned.

  • Makes timely and effective decisions using data and takes a fact-based approach to problem-solving, while understanding the limits of data to make and support decisions.

  • Establishes the Medicaid Regulatory Affairs strategy and oversees contract administration activities in markets.

  • Manages and supports audits and implementations to ensure regulatory requirements are satisfied.

  • In partnership with Corporate Compliance, develops procedures, toolkits and reports and monitors contractually required deliverables, including but not limited to, regulatory reports and performance metrics.

  • Develops procedures and toolkits for Account Management Plans and monitors adherence with corporate processes.

  • Directs and manages a team of associates responsible for supporting Medicaid Regulatory Affairs initiatives and teams.

  • Supports development and implementation of Regulatory Affairs in new markets.

  • Develops and manages department budget.

  • Performs special projects as needed.

Education:  A Bachelor's Degree in business administration or related field. Master's degree in public policy, public health, political science, health administration or related field preferred.   

 

Experience:  10 years of combined experience in managed health care or health care consulting. 5 years of progressively responsible managerial experience. In-depth knowledge of government programs and the managed care industry and experience leading and managing regulatory affairs programs through teamwork, collaboration and open communication

 
Post Date:  02/13/2012

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