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Senior Director, Medical Informatics Job Details

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Company:  WellCare Health Plans, Inc.
Job Code:  1200080
Categories:  For-Profit Senior Services
Job Role:  Maintenance / Facilities Mgmt / Building & Grounds
Region/Province:  Florida (FL)
City:  FL-Tampa
Job Description:  !*!About WellCare: WellCare Health Plans, Inc. provides managed care services targeted to government-sponsored health care programs, focusing on Medicaid and Medicare. 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. For more information about WellCare, please visit the Company's website at www.wellcare.com.

Our History: Founded in 1985 with three associates, WellCare grew to more than 800 associates and 467,000 members in Florida, New York and Connecticut by 2002. In 2004, the company acquired Harmony to enter the Midwest and became publicly traded. By 2006, WellCare served 2.2 million members as it became a national prescription drug plan provider and the largest Medicaid plan in Georgia. WellCare expanded its services when it began offering Medicaid managed care plans in Ohio and Missouri in 2007, and Medicare managed care plans in Texas and New Jersey in 2008. Additional growth followed when the company was chosen to serve Hawaii's Medicaid program for the aged, blind or disabled in 2009, and in 2011 when it was selected to serve Kentucky's Medicaid program. Today, WellCare has more than 3,900 associates and approximately 2.4 million members nationwide.

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.



The Senior Director, Medical Informatics oversees all data reporting for the health care quality division, including HEDIS reporting, adhoc reports, state Medicaid quality reports for corporate use, Medicare reports, performance improvement project reports and member satisfaction reports.  In addition, the incumbent ensures that data sources are of the highest quality by working with staff members from other departments, such as Information Technology, serves and/or leads committees and workgroups tasked with data quality improvement, and works with all stakeholders at headquarters and in each market to formulate and implement action plans for data quality improvement.

 

Essential Functions:


  • In collaboration with the VP, Quality Management, provides leadership and strategic direction for medical informatics programs for member and health plan quality management.

  • Consults with and serves as a resource with other departments both within Health Services and throughout the organization, such as IT, marketing, product development, compliance and regulatory, and others as needed for the purpose of insuring coordination in systems planning, development, and implementation between the claims management system, the Enterprise Medical Management Application (EMMA), and internal applications and databases.

  • Conducts assessments of the medical informatics environment using data quality and stakeholder satisfaction metrics to synthesize pertinent information and identify implications for planning and development of both information services and data improvement programs.  These reviews will be summarized at regular intervals to provide a structured environmental assessment and recommendations relative to future direction for medical informatics for Health Services.

  • In collaboration with Health Services leaders and staff, identifying the needs of the Health Services Information System for member service quality reporting, and evaluation of performance improvement projects in the markets and at corporate headquarters.

  • Conducts ongoing technology assessment of medical information systems and products, related to identifying and meeting corporate and market needs.  Identifies opportunities for collaboration with vendors and other stakeholders to enhance information systems and reduce the burden of data entry and maintenance.

  • Manages the overall planning, development, and implementation of Health Services quality informatics programs, products and services, particularly to address the medical service needs of members, network providers, and other stakeholders.

  • Assesses training and development needs of Health Services staff in relation to use of electronic data resources.  Works collaboratively to develop curriculum for staff members and implementing programs to address needs.

  • Provides expert support to other departments as requested for development of quality assessment information systems, products and services responsive to current and future needs.  Advises on issues related to access and interface.  Tracks and advises on industry standards for information services.

  • In collaboration with appropriate staff, advises on prototype development, coordinates/conducts prototype, alpha and beta testing.

  • Assists in communicating results of prototype development to vendors and appropriate staff.

  • Serves as liaison with the staff and departments for the purpose of integrative program development in the area of quality evaluation and reporting with other divisions and departments throughout the enterprise.

  • Assists in developing product specifications including the application and functionality of software programs, software vendor requests for proposals, recruitment of vendors and evaluation of vendor's work for software acquisitions.

  • Assists in monitoring vendors' adherence to specifications, quality, and effectiveness of vendor support.

  • Assesses the needs and implements the strategies to link educational products, such as practice guidelines, to quality-based electronic medical record systems used throughout the corporation.

  • Collaborates with the leadership and departments in the development of new and enhanced quality review and improvement programs. Serves as the primary liaison for related activities and the overall integration of programs and products with enterprise-wide electronic data collection and reporting.

  • Performs special projects as needed.    




Education:  A Bachelor's Degree in Finance, Statistics, Math or relevant field     

 

Experience: 


  • Advanced training in medical informatics with at least 10 years of experience in a medical informatics environment

  • Managed care experience is a plus

  • Solid understanding of quality improvement principles and clinical improvement implementation strategies

  • 5 years management experience


Licenses/Certifications:  Licensed Registered Nurse is a plus     

 

Special Skills (e.g. 2nd language): 


  • Excellent understanding of accreditation, federal and state regulations/requirements

  • Excellent verbal and written communication skills

  • Strong analytical and problem solving skills

  • Ability to communicate effectively with people with varying levels of education

  • Ability to multitask in a fast paced environment


Technical Skills/Requirements: 


  • Advanced in Microsoft Excel, Word, Visio, PowerPoint, Access, and Outlook

  • Ability to use Microsoft Access and SQL to create queries 

  • Proficiency in SAS, SQL, UNIX, and ORCL is a plus

Post Date:  03/17/2012

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