Physician Business Manager

UnitedHealth Group • Austin, TX

101d • $58,800 - $105,000 • Onsite

About The Position

The Physician Business Manager is responsible for developing, maintaining and servicing a high quality, marketable and satisfied provider network within an assigned geographic area. Key responsibilities include recruitment and contracting, education and servicing of assigned providers. The Physician Business Manager helps assigned Providers operate successfully within our healthcare delivery model by providing strategic planning and tools to meet goals. This position is expected to build and sustain solid working relationships with cross functional departments, vendors, local sales, and assigned Providers. The Physician Business Manager is accountable for overall performance and profitability for their assigned groups as well as ownership and oversight to provide redirection as appropriate.

Requirements

• 2+ years of provider relations or managed care experience
• Experience in sales, contract negotiation, or influencing provider participation in health plans
• Proven ability to interface effectively both internally and externally with a wide range of people including physicians, office staff, hospital executives and other health plan staff

Nice To Haves

• Experience presenting to small and large groups
• Knowledge of local provider community
• Proven analytical and problem solving skills with effective follow through
• Proven solid verbal and written communication skills

Responsibilities

• Educate Providers to ensure they have the tools they need to meet Quality, Risk adjustment, growth (as appropriate) and Total Medical Cost goals per business development plans
• Ensures Providers have in depth understanding of WellMed Model of Care to include, but not limited to, contractual obligations, program incentives and patient care best practices
• Conduct detailed analysis of various reports by tracking and trending data to develop a strategic plan to ensure performance goals are achieved
• Ensures the overall strategic plan incorporates interventions with internal departments or subject matter experts, external vendors, and others as needed
• Participates in creation and execution of a local network development plan to assure network adequacy as needed
• Works at the direction of their assigned leader to recruit/contract providers ensuring network adequacy
• Conducts new provider orientations and ongoing education to providers and their staffs on healthcare delivery products, health plan partnerships, processes and compensation arrangements
• Maintains open communication with providers to include solutions for resolution and closure on health plan issues related to credentialing, claims, eligibility, disease management, utilization management, quality and risk adjustment programs
• Conducts provider meetings to share and discuss economic data, troubleshoots for issue resolution, and implements an escalation process for discrepancies
• Collaborates with provider groups to develop, execute and monitor performance and patient outcomes improvement plans
• Collaborates with Medical Director to monitor utilization trends and profit pools and share results with assigned PCPs
• Handles or ensures appropriate scheduling, agenda, materials, location, meals and minutes of provider meetings as needed
• Collaborates with contracting team to ensure provider data is correct and Provider directories include any needed updates. Completes Practitioner Data Forms and Provider Change Forms as needed
• Represent WellMed/UHG by holding company sponsored Provider events (Summits, Learning Sessions)
• Provides information and participate in management meetings as requested
• Regularly meets with cross functional team to create, revise and adjust strategy for assigned Provider Groups to meet overall performance goals
• Provider support to maintain and develop ongoing value related to the WellMed Value Proposition
• Introduce and advocate company resources to facilitate practice optimization
• Identifies at risk situations and develops a plan for escalation and corrective action
• Performs all other related duties as assigned

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Industry: Insurance Carriers and Related Activities