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Physician Account Executive [Tobyhanna]

Description
Purpose:
UPMC Health Plan is seeking a Physician Account Executive for their Northeastern PA region.
This role will manage relationships with strategic high volume physician practices within the UPMC Health Plan service area. Provide assistance and support to other assigned physician practices and its staff enabling them to resolve daily operational issues, as necessary. Evaluate the effectiveness of physician practice clinical and operational processes and assist the practice in developing action plans and identifying resources to impact change. Present provider reports to physicians and staff and lead a team of professionals, who will be instrumental in improvement of patient outcomes, member satisfaction and cost control. Work with a broad spectrum of UPMC Health Plan personnel, network providers, and external resources to complete all tasks related to network management projects, goals and objectives.
NEPA (Northeastern PA) team is located in the northeastern part of the state building a robust network for all UPMC products. Knowledge of health plan contracting , products and provider relations.
This role will generally be working from home with regional traveling required for contracting providers and periodic traveling to Pittsburgh.
Responsibilities:
Assist Manager in coordination of staff development and training. Mentor by accompanying Network Managers to appointments when needed.
Assist in development of plans, by market segment to increase UPMC Health Plan patient base with key accounts. Determine provider role in these activities.
Create and lead team to impact change.
Distribute provider reports, lead development and implementation of action plans.
Identify, document and distribute best practice information.
Manage relationships with key high volume accounts within the UPMC Health Plan physician network.
Manage special projects assigned by manager and department director.
Meet deadlines and turnaround times set by manager and department director (these deadlines and turnaround times will, at times, require the employee to work until the project is completed, meaning extended daily work hours, extended work weeks, or both).
Meet with targeted physician practices to assess practice patterns and make recommendations to improve provider performance.
Monitor ongoing performance of practices and report findings to physicians to help improve clinical and operational performance.
Provide information on plan resources to assist.
Track and document success and report results to practice and to management.
Qualifications
B.A. degree in business, health care, finance, or related field or
Five (5) years of experience in managed care/physician office setting required.
Excellent verbal and written communication skills, analytical and organizational skills are required.
Extensive problem solving experience is required.
Presentation experience and experience working with physicians.
Goal-oriented and have experience with development and implementation of action plans.
Leadership skills are desired.
Excellent project management, analytical, organizational, and customer service skills are required.
Ability to work within an aggressive service-based environment.
Ability to continuously interact effectively with all Health Plan departments is critical.
Ability to effectively manage relationships with assigned strategic practices and keep accurate records of all activity for reporting purposes.
Ability to develop and analyze focused action plans for key accounts.
Minimal direction required. Ability to present information to management in a clear and professional manner. Results-oriented and self-motivated.
Licensure, Certifications, and Clearances:
UPMC is an equal opportunity employer. Minority/Females/Veterans/Individuals with Disabilities


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