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Senior Director Hospital Contracting

TampaWellCare


Manages physician contracting, network development and provider service functions for hospitals throughout Florida. Works in concert with medical management, sales, provider operations and provider service center personnel in developing actions to meet market growth and medical cost targets, and customer service excellence.
 
Reports to:  VP, Field Network Management
Dept.: FL-Network Development-State
Location: Tampa, FL

 
Essential Functions:
  • Develops a comprehensive network strategy to support market growth and medical cost targets.
  • Negotiates and renegotiates contracts with hospitals.
  • Establishes effective departmental practices and work closely with various departments (operations, regulatory, sales, etc.) to ensure contracts meet operating, financial and legal standards.
  • Heavy emphasis on analyzing cost and utilization data to develop specific actions to manage medical cost trend.
  • Ensures compliance with government programs such as Medicaid and Medicare for all contracting and network development purposes.
  • Identifies areas to improve provider service levels within operating budget parameters.
  • Creates and distribute provider and hospital communications ie: letters, newsletters, training materials, etc. to educate and enhance relationships within the provider community.
  • Perform other duties as assigned.

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