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   Current UPMC employees must apply in HR Direct

Ancillary Network Manager

Description

UPMC Health Plan has an exciting opportunity for an Ancillary Network Manager in its National Network Management department, located in downtown Pittsburgh at the U.S. Steel Tower.  This is a Monday - Friday daylight position that will work in the office 3 days per week with the other 2 days spent out in the field.

This role ensures the delivery of high-quality, cost-efficient healthcare services to mutual customers of UPMC Health Plan. The Network Manager is responsible for establishing goals for the ancillary 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:

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

 

Qualifications

  • Bachelor's Degree in business, health care, management, or a related field is preferred or equivalent experience is required.
  • 3 years of experience in healthcare industry or professional business industry.
  • Health insurance experience 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

UPMC is an Equal Opportunity Employer/Disability/Veteran

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   Current UPMC employees must apply in HR Direct