Job Description

Job Title: Manager, Ancillary Network Services
Job ID: 623484
Status: Full-Time
Regular/Temporary: Regular
Hours:
Shift: Day
Facility:
Department: Community HealthChoices
Location: 123 S. Broad Street, Philadelphia PA 19109

Description

Purpose:
UPMC Health Plan is hiring a full-time Manager, Ancillary Network Services to help support the Community Health Choice Department. This position will provide service to the Philadelphia area and its environments. This is a Monday through Friday daylight position. Under the general direction of the Director, Ancillary Network Services, the Manager, Ancillary Network Services, assumes responsibility for managing and directing all activities related to the management of the Ancillary Dental and Vision network, including contracting, negotiating, education and recruiting. This position is responsible for providing leadership and direction to director and Dental & Vision Ancillary Network Manager staff to meet or exceed UPMC Health Plan business objectives.

Responsibilities:
  • Analyze and trend data to identify inefficiencies and implement process improvement; Lead workgroups that encompass end users, developers, and others to identify problems and implement solutions.
  • Control expenses while meeting operational, financial, and service requirements in a fast-paced managed care operations environment.
  • Coordinate Ancillary, Dental and Vision Product recruitment and network filing as necessary.
  • Develop strategic and tactical business plans to achieve corporate business objectives.
  • Identify areas of potential compliance risk and develop solutions for risk mitigation.
  • Identify critical business objectives; develop and implement business plans to support critical objectives
  • Interact extensively with internal and external customers to build and maintain positive relationships supporting business goals and regulatory compliance.
  • Maintain a positive work environment for direct reports, including Ancillary Dental and Vision Network Managers and other related Ancillary services positions.
  • Maintain compliance accountability specific to products in accordance with state and federal law(s).
  • Oversee the development/refinement of policies and procedures, workflows, and reporting development.
  • Participate in all phases of the recruitment and management of staff.
  • Provide leadership and direction through developing and updating procedures, determining appropriate standards and procedures, determining staffing requirements, and training opportunities.
  • Provide leadership and direction with contracting and negotiating ancillary network providers.
  • Provide leadership and direction, support professional growth by providing training opportunities and appropriate resources.
  • Provide training for UPMC Health Plan Staff accordingly.
  • Responsible for implementation, oversight, and day to day operations of UPMC Health Plan's Ancillary, Dental and Vision products.

Qualifications

  • Bachelors Degree preferred or equivalent business experience
  • Five (5) years experience in managed care required
  • Management experience preferred
  • Preferred knowledge of Ancillary, Dental and Vision products and services, systems processes, and implementation and oversight of ancillary services.
  • Preferred knowledge of Ancillary, Dental and Vision contracting, negotiation and claims administration.
  • Strong Project Management background
  • Proficient of Microsoft Office products and PC skills required;
  • Proven process improvement and project management expertise required.
  • Demonstrated ability to effectively influence others to accomplish Health Plan business objectives
  • Ability to react to users and clients needs in a timely and efficient manner and direct staff with minimal amount of supervision.
  • Strong leadership skills and independent decision making ability.

    Licensure, Certifications, and Clearances:
    UPMC is an equal opportunity employer. Minority/Females/Veterans/Individuals with Disabilities

Salary Range: $29.99 to $51.22

Union Position: No

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