Senior Physician Business Manager - WellMed - North Texas

UnitedHealth Group•Forney, TX

3d•$72,800 - $130,000•Hybrid

About The Position

This position functions as a subject matter expert in network operations. This position strives to bring consistency and experience to existing Physician Business Managers in the local market by analyzing, reviewing, forecasting, trending, and presenting information for operational and business planning. This position will organize and assist the local Physician Business Managers in achieving short and long term operational/strategic business goals/ by developing, enhancing and maintaining operational information and models. They also develop, in conjunction with the local Director/Manager, and implement effective/strategic business solutions through research and analysis of data and business processes. This is a North Texas-based hybrid role requiring 75%25 field travel to physician practices in the assigned territory, including Plano, McKinney, Allen, Irving, Little Elm, Forney, The Colony, Farmers Branch, Paris, Tyler, Center, and surrounding areas

Requirements

5+ years of experience in a related medical field or health plan setting (network management, contracting and/or recruitment, or provider relations)
Proven knowledge of Managed Care and Medicare programs
Ability to develop long-term positive working relationships
Ability to communicate and facilitate strategic meetings with groups of all sizes
Proven solid business acumen, analytical, critical thinking and persuasion skills
Proven exceptional interpersonal skills with ability to interface effectively internally with all levels of staff and externally with a wide range of people including physicians, office staff, hospital executives, medical groups, IPA’s, the press and community organizations
Proven solid verbal and written communication skills
Proficiency in Microsoft Word, Excel and PowerPoint
Demonstrated solid presentation skills, problem solving and ability to manage conflict and identify resolutions quickly
Ability to communicate well with physicians, staff and internal departments
Driver’s License and access to reliable transportation

Nice To Haves

Risk Adjustment knowledge related to CMS reimbursement models
Ability to act as a mentor to others

Responsibilities

Analyzes risk pool and provider group performance to determine areas of focus or improvement opportunities
Develops strategies to align contracted provider groups with company initiatives, goals (revenue and expense) and quality outcomes
Create and develop action plans to achieve metrics in quality, coding and financial performance.
Provides explanations and interpretations within area of expertise
Provides daily direction and guidance to existing local Physician Business Managers and acts as the subject matter expert for their assign area
Uses pertinent data and facts to identify and solve a range of problems through experience, research and collaboration
Assists local Physician Business Managers with investigating non-standard requests and problems
Prioritizes and organizes assigned workload of local Physician Business Managers is able to meet deadlines while delivering the best outcomes possible
Provides explanations, direction and information to others on topics within area of expertise
Collaborates with local Medical Director(s) to monitor utilization trends and profit pools to assist with developing strategic plans to improve performance
Solid analytical skills required to support, compile and report key information
Drive processes and technology improvement initiatives that directly impact Revenue, HEDIS/STAR measures and Quality Metrics, using standard project methodology (requirements, design, test, etc.)
Use data to identify trends, patterns and opportunities for the business and clients. Develop business strategies in line with company strategic initiatives
Engage provider staff and providers in analysis and evaluation of functional models and process improvements; identify dependencies and priorities
Evaluate and drive processes, provider relationships and implementation plans
Produce, publish and distribute scheduled and ad-hoc client and operational reports relating to the development and performance of products
Collaborate with other Physician Business Manager- Area Leads to foster teamwork and build consistency throughout the market
Serves as a liaison to the health plan and all customers