Job Description

Job Title: Ancillary Network Manager [Philadelphia area]
Job ID: 621661
Status: Full-Time
Regular/Temporary: Regular
Hours:
Shift: Day Job
Facility: UPMC Health Plan
Department: Den_Vision Ancillary
Location: 123 S. Broad Street, Philadelphia PA 19109

Description

Purpose:
UPMC Health Plan is hiring a full-time Ancillary Network Manager to help support the Dental and Vision Ancillary Network Department. This position will provide service to the Philadelphia area and its environments and is a Monday through Friday daylight position.

 

The Network Manager will lead a team of professionals that will work in collaboration with network providers to ensure delivery of high quality, cost efficient healthcare services to mutual customers of UPMC Health Plan. The Network Manager will be responsible for establishing goals for the department that lead to not only the department's success, but also the overall success of UPMC Health Plan. The Network Manager will interact with other internal and external customers to set appropriate goals and establish priorities for the Network Management staff.

Responsibilities:

  • Assess the operational patterns of the practice and recommend actions to assist the provider in performance improvement.
  • Assist with network expansion activities as needed.
  • Coordinate problem resolution for providers as necessary and ensure ongoing collaboration with providers to support Health Plan initiatives.
  • Determine the causes of financial and clinical trends, anomalies and communicate these findings to physicians.
  • Ensure ongoing provider communications and training for office staff.
  • Identify opportunities to improve clinical and financial performance.
  • Present provider profiling reports to network providers.

Qualifications

  • Bachelors Degree in business, health care, management, or a related field is preferred or equivalent experience is required,
  • 3 years of experience in health care industry or professional business industry
  • Previous Health Insurance Provider experience is highly preferred
  • Ability to forge strong interpersonal relationships within the department, other departments, and with the physician network.
  • Strong leadership, planning, communication, documentation, organizational, analytical, and problem solving abilities.
  • Ability to interpret and summarize results of various analyses in a timely manner.
  • Ability to re-engineer processes to positively impact the performance of the department and the Health Plan, as well as individual provider offices.
  • Ability to analyze financial and clinical results and to comprehend forecasting models.
  • Willingness to travel extensively to regional service area within Pennsylvania
  • Demonstrated ability to work independently and manage assigned territory

    Licensure, Certifications, and Clearances:
    Valid Pennsylvania Driver's License required

  • Driver's License

UPMC is an equal opportunity employer. Minority/Females/Veterans/Individuals with Disabilities

Salary Range: $21.94 to $37.97

Union Position: No

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