Senior Physician Business Manager

UnitedHealth Group • Austin, TX

156d • $71,200 - $127,200 • Onsite

About The Position

Opportunities at WellMed, part of the Optum family of businesses. We believe all patients are entitled to the highest level of medical care. Here, you will join a team who shares your passion for helping people achieve better health. With opportunities for physicians, clinical staff and non-patient-facing roles, you can make a difference with us as you discover the meaning behind Caring. Connecting. Growing together. 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.

Requirements

• 5+ years of experience in a related medical field or health plan setting (network management, contracting and/or recruitment, or provider relations)
• Knowledge of Managed Care and Medicare programs
• Proficiency in Microsoft Word, Excel and PowerPoint
• Proven ability to develop long-term positive working relationships
• Proven 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
• Driver's License and access to a reliable transportation

Nice To Haves

• Risk Adjustment knowledge related to CMS reimbursement models
• Proven 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 assigned 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 to meet deadlines while delivering the best outcomes possible
• Collaborates with local Medical Director(s) to monitor utilization trends and profit pools to assist with developing strategic plans to improve performance
• Drive processes and technology improvement initiatives that directly impact Revenue, HEDIS/STAR measures and Quality Metrics, using standard project methodology
• Use data to identify trends, patterns and opportunities for the business and clients
• Engage provider staff and providers in analysis and evaluation of functional models and process improvements
• 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

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
• Education Level: Bachelor's degree