Physician Business Manager - East Texas Market

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 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.

Primary Responsibilities:

Service Excellence:

• Serves as a 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. Engages with Sr. Physician Business Managers as appropriate to gain further insights and knowledge on a best practice approach to issue resolution.
• Proactively identifies issues and determines root cause so that they can be resolved timely and completely. Partners with Sr. Physician Business Managers as appropriate to investigate and troubleshoot non-standard requests and concerns. Escalates issues as appropriate to leadership.
• Builds collaborative relationships with between the Organization and Contracted and Affiliated physicians and their office staff.
• Under the guidance of a Sr. Physician Business Manager, works to prioritize and organize 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.

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. Engages with Physician Business Managers as appropriate to gain further insights and knowledge around utilization trends, and best practices to drive performance and engagement.
• 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.

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:

• 3+ years' experience in a related medical field or health plan setting (network management, contracting and/or recruitment, or provider relations).
• Ability to develop long-term positive working relationships.
• Strong 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.
• Strong verbal and written communication skills.
• Face-to-face sales or customer service experience.
• Proficiency in Microsoft Word, Excel, PowerPoint, and Access
• Ability to work independently, use good judgment and decision making processes.
• Travel up to 50% of the time.
• Ability to adapt quickly to change in an ever-changing environment.

Preferred Qualifications:

• Experience in group presentations and training.
• Professional provider relations experience involving physicians and administrative staff.
• Provider recruitment and contracting experience.
• Knowledge of Managed Care and Medicare programs.
• Bilingual proficiency in English/Spanish preferred.
• Risk Adjustment knowledge related to CMS reimbursement models.
• Understanding of medical care delivery model and local market business dynamics.

The salary range for this role is $71,600 to $90,000 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. UnitedHealth Group complies with all minimum wage laws as applicable. In addition to your salary, UnitedHealth Group offers 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 UnitedHealth Group, you'll find a far-reaching choice of benefits and incentives.

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.

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