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.The Physician Business Manager is a subject matter expert in network operations. This role is responsible for the operations of the provider network in their assigned region, and is the direct interface between the Organization and the Contracted or Affiliated physician network. This position provides continuous education, support, training and troubleshooting to physicians and their staff. This role serves as the liaison between the Organization’s central departments and the physician network to assist in the achievement of short and long-term operational and strategic goals. The Physician Business Manager role is instrumental in the support of larger, higher volume, higher spend provider groups or specialities; often associated with greater complexity and nuance in their daily operations.If you are located in Waco or Dallas Fort Worth , you will have the flexibility to work remotely , as well as work in the facilities you support, as you take on some tough challenges.Primary Responsibilities:Service Excellence:
Serves as single-point-of-contact to the physician network and is an accountable owner, responsive to physician needs. Knowledgeable about incentive programs, contract reimbursement, practice and network profitability, ACOs and other Enterprise initiatives, as applicable
Responds timely to provider issues, works with other groups/central departments to resolve issues and updates providers and office staff regularly through to resolution
Proactively identifies issues and determines root cause so that they can be resolved timely and completely. Escalates issues as appropriate to leadership
Builds collaborative relationships with between the Organization and Contracted and Affiliated physicians and their office staff
Prioritizes and organizes assigned workload while still meeting deadlines and delivering the best outcome possible
Presence & Visibility:
Adheres to scheduled cadence for touchpoints and ensures that agreed upon agenda is followed and action items are documented and tracked
Attends external office staff meetings and community/town hall meetings, as required, and completes any action items that may arise from those meetings
Represents the organization by holding company sponsored provider events (Summits, Learning Sessions, etc.)
Maintains awareness of providers interested in further engaging with the Organization on new business opportunities (contracts and business combinations), and on shifting market/competitive dynamics that would impact the Organization
Leads Joint Operating Committee (JOC)meetings with key stakeholders to discuss group’s current performance against key performance indicators (KPIs), patient outcomes, operating costs and viability for long term success
Provider Training and Adherence:
Serves as ambassador to our value-based care model; providing continuous onsite education around our organization’s programs and unique approach to patient care
Onboards new physicians and their office staff
Works with office staff to develop and maintain adherence to Optum processes. Remains available to answer questions and train staff on various portals and other resources available
Handles or ensures appropriate scheduling, agenda, materials, location, meals and minutes of provider meetings as needed
Educates physicians on performance-based incentive programs
Ensures that the physicians and their office staff receive and understand various organization-issued communications
Evaluates training needs for physicians and offices, and ensures the timely delivery of needed training
Analyzes trends of contracted provider visits and reviews all outlying visits to target areas of opportunity to provide re-education
Clinical Quality and Patient Satisfaction:
Regularly educates offices on their current performance against key performance indicators (KPIs)
Monitors performance of assigned PCPs, identifies areas of opportunity and works with Market leadership to develop action plans for specific metrics needing improvement
Works with office to effectuate change; monitors progress; intervenes and escalates matters as appropriate
Engages, seeks assistance and intervention from Market Medical Director and/or Quality Manager when needed
Remains knowledgeable about the various quality measures and improvement programs Optum provides, and educates the offices on how to drive the benefits of a value based care model
Supports and helps practices to optimize performance based goals related to Clinical Quality and Patient Satisfaction measures.
Engages Contracted and Affiliated physicians and staff in enhancing quality and patient satisfaction
Growth and Retention:
Works collaboratively with offices, Optum marketing team and brokers to drive membership growth and retention
Monitors and identifies trends on membership decline and escalates to leadership as appropriate
Addresses PCP specific issues identified as part of dis-enrolled member calls
Assists with Annual Enrollment Period (AEP) efforts by working with offices, marketing team, and brokers; attends AEP events with marketing to strengthen relationships with PCPs
Subject Matter Expert:
Provides daily direction and guidance to existing local Physician Business Managers and acts as the subject matter expert for their assigned area
Assists local Physician Business Managers with investigating non-standard requests and problems
Prioritizes and organizes assigned workload of local Physician Business Managers to ensure key deliverables are met while delivering the best outcomes possible
Produces, publishes and distributes scheduled and ad-hoc client and operational reports relating to the development and performance of products
You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.Required Qualifications:
5+ years of experience in a related medical field or health plan setting (network management, contracting and/or recruitment, or provider relations)
Face-to-face sales or customer service experience
Experience in group presentations and training
Knowledge of Managed Care and Medicare programs
Ability to develop long-term positive working relationships
Solid interpersonal skills with ability to interface effectively both externally and internally with a wide range of people including physicians, office staff and other health plan staff
Excellent problem-solving skills with effective follow through
Solid verbal and written communication skills
Solid business acumen, analytical skills, critical thinking, and persuasion skills
Proficiency in Microsoft Word, Excel, PowerPoint, and Access
Ability to work independently, use good judgment and decision-making processes
Ability to adapt quickly to change in an ever-changing environment
Ability to travel up to 50% of the time
Preferred Qualifications:
Professional provider relations experience involving physicians and administrative staff
Risk Adjustment knowledge related to CMS reimbursement models
Understanding of medical care delivery model and local market business dynamics
Bilingual proficiency in English/Spanish
Physical & Mental Requirements:
Ability to lift up to 25 pounds
Ability to push or pull heavy objects using up to 25 pounds of force
Ability to sit for extended periods of time
Ability to stand for extended periods of time
Ability to use fine motor skills to operate office equipment and/or machinery
Ability to properly drive and operate a company vehicle
Ability to receive and comprehend instructions verbally and/or in writing
Ability to use logical reasoning for simple and complex problem solving
At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.
