Physician Business Manager, WellMed - East, TX

Company: UnitedHealth Group
Location: Tyler
Posted on: January 15, 2022

Job Description:

Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve - your life's best work.(sm)

The Physician Business Associate with WellMed is responsible for developing, maintaining, and servicing a high quality, marketable, and satisfied provider network within an assigned geographic area. Key responsibilities include recruitment and contracting, education, and servicing of assigned providers. The Physician Business Associate helps assigned providers operate successfully within our healthcare delivery model by providing strategic planning and tools to meet goals. This position is expected to build and sustain strong working relationships with cross functional departments, vendors, local sales, and assigned providers. The Physician Business Associate is accountable for overall performance and profitability for their assigned groups, as well as ownership and oversight to provide redirection as appropriate.

Primary Responsibilities:
Educate providers to ensure that they have the tools they need to meet quality, risk adjustment, growth (as appropriate), and total medical cost goals per business development plans
Ensure providers have in-depth understanding of WellMed Model of Care to include, but not limited to, contractual obligations, program incentives, and patient care best practices
Conduct detailed analysis of various reports by tracking and trending data to develop a strategic plan to ensure performance goals are achieved
Ensure the overall strategic plan incorporates interventions with internal departments or subject matter experts, external vendors, and others, as needed
Participate in creation and execution of a local network development plan to assure network adequacy as needed
Work at the direction of your assigned leader to recruit/contract providers, ensuring network adequacy
Conduct new provider orientations and ongoing education to providers and their staffs on healthcare delivery products, health plan partnerships, processes, and compensation arrangements
Maintain open communication with providers to include solutions for resolution and closure on health plan issues related to credentialing, claims, eligibility, disease management, utilization management, quality, and risk adjustment programs
Conduct provider meetings to share and discuss economic data, troubleshoot for issue resolution, and implement an escalation process for discrepancies
Collaborate with provider groups to develop, execute, and monitor performance and patient outcomes improvement plans
Collaborate with Medical Director to monitor utilization trends and profit pools and share results with assigned PCPs
Handle or ensure appropriate scheduling, agenda, materials, location, meals, and minutes of provider meetings as needed
Collaborate with contracting team to ensure provider data is correct and provider directories include any needed updates
Complete Practitioner Data Forms and Provider Change Forms as needed
Represent WellMed/UHG by holding company sponsored provider events (summits, learning sessions)
Provide information and participate in management meetings as requested
Regularly meet with cross functional team to create, revise, and adjust strategy for assigned provider groups to meet overall performance goals
Provide support to maintain and develop ongoing value related to the WellMed Value Proposition
Introduce and advocate company resources to facilitate practice optimization

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:
High school diploma or equivalent
2+ years of provider relations or managed care experience
Experience with making presentations to both small and large groups
Intermediate level of -proficiency with MS Suite (including Word, PowerPoint, and Excel)
Ability to work evenings and weekends on occasion based on business needs
Full COVID-19 vaccination is an essential requirement of this role. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination prior to employment to ensure compliance
Preferred Qualifications:
Advanced degree
Understanding of medical care financing and delivery systems, provider contracting, reimbursement arrangements, and network management
Established knowledge of local provider community
Excellent analytical and problem-solving skills with effective follow through
Exceptional interpersonal skills with ability to interface effectively both internally and externally with a wide range of people including physicians, office staff, hospital executives, and other health plan staff

UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.

Careers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 550,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.(sm)

WellMed was founded in 1990 with a vision of being a physician-led company that could change the face of healthcare delivery for seniors. Through the WellMed Care Model, we specialize in helping our patients stay healthy by providing the care they need from doctors who care about them. We partner with multiple Medicare Advantage health plans in Texas and Florida and look forward to continuing growth.

Diversity creates a healthier atmosphere: OptumCare is an Equal Employment Opportunity/Affirmative Action employers 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.

OptumCare is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Job Keywords: Healthcare, Health Care, Managed Care, Medicare, Provider Relations, Provider Network, Provider Education, Quality, Risk Adjustment, Network Development, WellMed, Travel, Dallas, TX, Texas

Keywords: UnitedHealth Group, Tyler , Physician Business Manager, WellMed - East, TX, Executive , Tyler, Texas