Senior Physician Business Manager - WellMed - North Texas

Optum; Dallas (TX); Hybrid; USD 73,000 - 130,000; Full time

Benefits offered by this job

Benefits package

401k program

Job summary

WellMed, part of the Optum family, seeks a subject matter expert in network operations in the North Texas area. Hybrid role with ~75% field travel to physician practices including Plano, McKinney, Allen, Irving, and nearby cities.

You’ll analyze risk pools, forecast performance, and develop strategic plans with local Physician Business Managers to drive revenue, expense control and quality outcomes. The role requires 5+ years in healthcare settings, knowledge of Managed Care and Medicare, strong

Qualifications

• 5+ years in a related medical field or health plan setting.
• 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 verbal and written communication skills.
• Proficiency in Microsoft Word, Excel and PowerPoint.
• Driver's License and access to reliable transportation.

Responsibilities

• Analyzes risk pool and provider group performance to identify improvement opportunities.
• Develops strategies to align provider groups with company goals and quality outcomes.
• Creates action plans to achieve metrics in quality, coding and financial performance.
• Provides explanations and interpretations within area of expertise.
• Guides local Physician Business Managers and acts as SME for the area.
• Uses data to identify trends and develop business strategies.

Skills

Analytical skills

Business acumen

Critical thinking

Persuasion skills

Communication skills

Interpersonal skills

Tools

Microsoft Word

Microsoft Excel

PowerPoint

Job description

Explore opportunities with WellMed, part of the Optum family of businesses. We believe all patients are entitled to the highest level of medical care. Here, you will be part of a team who shares your passion for helping people achieve improved health outcomes. Join us and 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.

This is a North Texas-based hybrid role requiring 75% 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.

Primary 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

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)
• 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

Preferred Qualifications

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

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $72,800 - $130,000 annually based on full-time employment. We comply with all minimum wage laws as applicable.

At UnitedHealth Group, our mission is to help people live healthier lives and help make the health system work better for everyone. Together, we are shaping the future of healthcare by harnessing technology and innovation to make care simpler to navigate, more affordable and more connected for the people we serve. We are committed to creating an inclusive workplace where everyone feels welcomed, valued, heard and respected, empowering people to bring their authentic selves to work and strengthening our collective impact through diverse talents, backgrounds, experiences and perspectives.

UnitedHealth Group and its affiliated brands are an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

UnitedHealth Group and its affiliated brands are a drug-free workplace. Candidates are required to pass a drug test before beginning employment.