Will lead overall Kentucky plan operation
LEXINGTON, Ky. (Oct. 31, 2016) — Bill Jones has been named president of WellCare’s Medicaid and Medicare Advantage businesses across Kentucky.
Jones will be responsible for the overall Kentucky plan operation, including strategic direction and the development of new programs. He will also direct provider contracting and relations, sales and marketing, medical management, and regulatory compliance.
Jones previously worked at Highmark, Inc., in Pittsburgh, where he served as vice president of Payment Integrity and Government Business Operations. In that role, he launched improvements to increase service-level performance, delivered millions in bottom line savings and was responsible for a multimillion-dollar effort to reconfigure enrollment and billing.
Prior to that he was the chief operating officer for CalOptima, Orange County, Calif’s largest Medicaid and Medicare health plan, which serves more than 800,000 members. While there, he led a major turnaround that resulted in the plan successfully resolving a Medicare sanction and earning the highest NCQA state ranking for Medicaid plans in California.
He earned a Bachelor of Social Science from Mercyhurst College and his MBA at Duke University.
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