Senior Provider Network Advocate — Partnerships & Performance

UPMC; Pittsburgh, Northern (Allegheny County, KY); Hybrid; USD 110,000 - 140,000; Full time

Job summary

UPMC is seeking a Senior Provider Network Advocate to lead issue resolution, coordinate provider outreach, and drive operational improvements across the Provider Network Liaison team. The role supports the Director, Network Management and ISD leadership while engaging with providers to improve performance, quality outcomes, and member satisfaction.

The position is hybrid with in-office requirements three days per week in Downtown Pittsburgh, offering opportunities to influence provider strategy

Responsibilities

• Present HP programs and tools internally to PNLss, other PNAs, and ISD departments as necessary.
• Present programs and tools to network providers and staff.
• Follow up with provider as necessary to ensure understanding.
• Act as a resource to PNLs and other PNAs.
• Train new staff as directed.
• Coordinate problem resolution for providers identified through internal reports and by the PNL team or ISD leadership.
• Identify root causes, swiftly take the needed steps to resolve the issue and ensure closed feedback loop to the PNL and/or provider occurs.
• Document provider outreach and initiative progress in a customer relationship database in a timely manner.
• Facilitate face-to-face visits with providers as directed.
• Foster strong relationships through collaboration with PNLs, other PNAs, other Network leaders, and other Provider Strategy and Performance staff to ensure process improvement within the department and between departments.
• Ability to manage relationships with key providers within the Health Plan provider network.
• Effectively lead and manage special projects assigned by the Department Director, and work collaboratively with the PNLs and other Network team members.
• To complete assigned tasks and projects in a timely manner, occasionally, the employee will need to extend hours beyond 40 hour work week.

Job description

UPMC is seeking a Senior Provider Network Advocate to lead issue resolution, coordinate provider outreach, and drive operational improvements across the Provider Network Liaison team. The role supports the Director, Network Management and ISD leadership while engaging with providers to improve performance, quality outcomes, and member satisfaction.

The position is hybrid with in-office requirements three days per week in Downtown Pittsburgh, offering opportunities to influence provider strategy