Job Description

Job Title: Network Manager - Ancillary LTSS
Job ID: 680415
Status: Full-Time
Regular/Temporary: Regular
Hours:
Shift: Day Job
Facility: UPMC Health Plan
Department: Community HealthChoices
Location: , Philadelphia PA

Description

UPMC Health Plan is hiring a full-time Ancillary LTSS Network Manager, to help support the Long Term Support Services (LTSS) Network for the Community HealthChoices Department. This position will provide service to the Philadelphia area and its environments. This is a Monday through Friday daylight position.

The Network Manager will support the Ancillary LTSS Network team and coordinate efforts with other HealthPlan departments. They will assist with provider operational initiatives including recruitment, contracting, orientations, ongoing education, and issue resolution. The Network Manager will outreach to providers as related to key departmental goals via phone, email and personal visits. They will assist in obtaining provider information and document their activity in a customer database. The Network Manager will assist in investigating claims issues and effectively communicate their findings to providers and external departments.


Responsibilities
  • Collaborate with other Network Leaders and staff to ensure process improvement within department.
  • Coordinate problem resolution for providers as necessary and ensure ongoing collaboration with providers.
  • Effectively manage special projects assigned by Manager, Department Director, Team Leads and Physician Account Executives. To complete in a timely manner, occasionally, the employee will need to extend hours beyond 40 hour work week.
  • Present various HP programs and tools to network providers and staff. Follow up with provider as necessary.

Qualifications

  • Bachelors Degree in Business, Health Care, Marketing or a related field is required or equivalent experience.
  • 3 years business/sales or healthcare-related experience required.
  • Knowledge of Waiver/LTSS/Home and Community Based Services and providers is highly preferred.
  • Strong written and verbal communication skills are required.
  • Demonstrated leadership, planning, communication, documentation, organization, analytic and problem solving abilities are required.
  • Ability to attend or accompany Manager/ PAE to various internal and external department and provider/hospital meetings.
  • Effectively interpret and summarize results of various analyses in a timely manner.

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

Salary Range: $22.60 to $39.11

Union Position: No

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