At UPMC, we are committed to keeping our community safe and healthy as the COVID-19 pandemic unfolds. As our team continues to provide Life Changing Medicine to our patients, our recruiters will continue to fill positions throughout this time. Interviews and other processes may be modified to protect the safety of our candidates and employees. Thank you for your patience.

For more information about UPMC's response to COVID-19, please visit upmc.com/coronavirus.

Job Description

Job Title: Manager, Network Management Operations
Job ID: 50413873
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 Manager, Network Management Operations in its National Network Management department, located in downtown Pittsburgh at the U.S. Steel Tower.


The Manager, Network Management Operations provides leadership and direction to the Network Management operational area by managing Network Management Operations to ensure regulatory compliance, provider, member satisfaction and operational efficiencies. In addition, this position maintains oversight and/or direct accountability for provider contracting process, reporting, compliance, financial analysis and planning and coordination of efforts with other departments to assure effective operations of the Network Management Department.

Responsibilities:

  • Specify personnel accountabilities and evaluate performance regularly.
  • Interacts extensively with internal and external customers to build and maintain positive relationships supporting business goals and objectives; acts as departmental liaison.
  • Ensures operational performance within the Network Management department through critical decision making that assures regulatory compliance and customer objectives are reached.
  • Oversee all aspects of contracting process and targeted provider communications.
  • Responsible for updating and creation of all department policies and procedures.
  • Ensures the attainment of the Health Plan's strategic business objectives by identifying, recruiting, developing, directing, and evaluating Health Plan personnel within the functional area.
  • Establishment and delegation of job duties for all positions within the functional area(s).
  • Participate in the development of the Network Management strategic business plan and creation and implementation of project plans to achieve Health Plan objectives.
  • Informs and advises Director of Network Development of current trends, issues, problems and activities in functional areas, and develops and implements appropriate interventions to facilitate problem resolution and policy making.
  • Responsible for the development of the yearly departmental budget.

 

Qualifications

  • Bachelor's Degree in Healthcare Administration, Hospital Administration, Business, Public Health or a closely related field required (Master's Degree in one of the aforementioned disciplines strongly preferred).
  • Three years of management experience in managed care plans (experience in Pennsylvania programs strongly preferred).
  • Excellent communication skills; verbal, written and interpersonal.
  • Above average analytical and problem solving skills.
  • Strong leadership skills and independent decision making ability.

    Licensure, Certifications, and Clearances:

    UPMC is an Equal Opportunity Employer/Disability/Veteran

Salary Range: $35.66 to $60.38 / hour

Union Position: No

Apply Current Employee?

UPMC VALUES

At UPMC, our shared goal is to create a cohesive, positive, experience for our employees, patients, health plan members, and community. If you too are driven by these values, you may be a great fit at UPMC!

QUALITY & SAFETY
DIGNITY & RESPECT
CARING & LISTENING
RESPONSIBILITY & INTEGRITY
EXCELLENCE & INNOVATION

UPMC provides a total rewards package that can help you achieve the goals you have for your career and your personal life. Whether you want to learn a new skill through a training course, reach personal health and wellness targets, become more involved in your community, or follow a career path that provides you with the right experience to be successful, UPMC can help you get to where you want to be.


WORKING HERE



Now more than ever, YOU can help us shape our communities and UPMC into a better place for everyone to work, study, play, and thrive.

Learn more about working here and check out our policies and recent updates.

UPMC Health Plan Named Best Places to Work for LGBTQ Equality in 2020


UPMC Ranked #1 Best Places for Women and Diverse Managers in 2019

Share:
Talent Network