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Job Description

Job Title: Network Manager - HPL
Job ID: 73583200
Status: Full-Time
Regular/Temporary: Regular
Hours:
Shift: Day Job
Facility: UPMC Health Plan
Department: Natl Network Mgmt
Location: 600 Grant St, Pittsburgh PA 15219

Description

UPMC Health Plan has an exciting opportunity for a Network Manager in its National Network Management department, located in downtown Pittsburgh at the U.S. Steel Tower. Although based in downtown Pittsburgh, this position will require occasional travel as needed.


The Network Manager will support the Physician Account Executive (PAE) team and coordinate efforts with other HP clinical departments. They will assist with provider operational initiatives including HCC, CDPS, MA P4P, and CMS Stars. 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:

  • Ability to manage relationships with key accounts within the Health Plan physician network is preferred.
  • 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.
  • Present various HP programs and tools to network providers and staff. Follow up with provider as necessary.
  • 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.

 

Qualifications

  • Bachelor's Degree in Business, Health Care, Marketing or a related field is required or equivalent experience.
  • 3 years business/sales or healthcare-related experience required.
  • 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/Disability/Veteran

Salary Range: $23.28 to $40.28 / hour

Union Position: No

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