Job Description

Job Title: Associate Network Manager
Job ID: 720821
Status: Full-Time
Regular/Temporary: Regular
Hours:
Shift: Day Job
Facility: UPMC Health Plan
Department: Den_Vision Ancillary
Location: 600 Grant St, Pittsburgh PA 15219

Description

The Associate Network Manager will work in collaboration with providers to recruit and contract them for participation in the UPMCHP provider network. Additionally, the Associate Network Manager will ensure delivery of high quality, cost efficient healthcare services to mutual customers of UPMC Health Plan. The Associate Network Manager will be responsible for executing the established goals of the department that lead to not only the department's success, but also the overall success of UPMC Health Plan. The Associate Network Manager will interact with other internal and external customers to respond to provider inquiries and resolve issues timely.

Responsibilities:
  • Assess the provider's needs and address all questions/concerns about the plan. Understand plan benefits of participation both for the member and the provider.
  • Assist the office in completing necessary paperwork for participation and ensure all items are accurate.
  • 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.
  • Ensure ongoing provider communications and training for office staff.
  • Identify available non-participating providers in a specified geographical region and present UPMCHP products and offerings for network participation.
  • If necessary, negotiate reimbursement and contract terms and obtain approval with Manager and/or Director.

Qualifications

  • Associates degree in business, healthcare, management or a related field (or pursuing a bachelors degree) and 2 years business/sales or healthcare-related experience OR 5 years business/sales or healthcare experience.
  • Self starter who is motivated and disciplined.
  • Ability to forge strong interpersonal relationships within the department, other departments, and with the provider 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.
  • Willingness to travel extensively to regional service area within Pennsylvania.
  • Demonstrated ability to work independently and manage assigned territory.

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

Salary Range: $17.11 to $28.43

Union Position: No

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