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)

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.

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
• Requires strong presentation skills, problem solving and ability to manage conflict and identify resolutions quickly
• Ability to communicate well with physicians, staff and internal departments
• The ability to travel locally, up to 50% as needed in the assigned territory of Pinellas County and Hillsborough County, Florida
• The ability to travel up to 5% as needed, to out of state markets such as Texas
  

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 healthcare/managed care experience or Bachelor’s Degree in Healthcare Management and/or a similar Degree
• 5+ years of experience in a related medical field or health plan setting (network management, contracting and/or recruitment, or provider relations)
• Experience communicating and facilitating strategic meetings with groups of all sizes
• Proficiency in Microsoft Word, Excel and PowerPoint
• Knowledge of Managed Care and Medicare programs
• The ability to travel locally, up to 50% as needed in the assigned territory within Pinellas County and Hillsborough County, Florida
• The ability to travel up to 5% as needed, to out of state markets such as Texas
• Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation

Preferred Qualifications:

• Risk Adjustment knowledge related to CMS reimbursement models
• Solid verbal and written communication skills
• Ability to act as a mentor to others
• Ability to develop long-term positive working relationships
• Solid business acumen, analytical, critical thinking and persuasion skills
• 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
  

To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment

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.