Physician Business Manager - Central Indiana
- United States
This position allows the flexibility to telecommute, but candidates must be local the Indianapolis, IN market since regular travel (50%-60%) to American Health Network's local offices will be required.
Find out what it means to be part of an exceptional company that values its employees, its role in health care, and making a difference one patient at a time. Take a look at American Health Network, part of Optum and explore a new path to your life's best work.(sm)
The Physician Business Manager is responsible for developing, maintaining and servicing a high quality, marketable and satisfied provider network within an assigned geographic area. Key responsibilities include recruitment and contracting, education and servicing of assigned providers. The Physician Business Manager helps assigned Providers operate successfully within our healthcare delivery model by providing strategic planning and tools to meet goals. This position is expected to build and sustain strong working relationships with cross functional departments, vendors, local sales, and assigned Providers. The Physician Business Manager is accountable for overall performance and profitability for their assigned groups as well as ownership and oversight to provide redirection as appropriate.
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Educates Providers to ensure they have the tools they need to meet Quality, Risk adjustment, growth (as appropriate) and total medical cost goals per business development plans
- Ensures Providers have in depth understanding of AHN Care Model to include, but not limited to, contractual obligations, program incentives and patient care best practices
- Conducts detailed analysis of various reports by tracking and trending data to develop a strategic plan to ensure performance goals are achieved
- Ensures the overall strategic plan incorporates interventions with internal departments or subject matter experts, external vendors, and others as needed
- Participates in creation and execution of a local network development plan to assure network adequacy as needed.
- Works at the direction of their assigned leader to recruit/contract providers ensuring network adequacy
- Conducts new provider orientations and collaborates with Executive Directors on ongoing education to providers and their staff on healthcare delivery products, health plan partnerships and compensation arrangements
- Maintains open communication with providers to include solutions for resolution and closure on health plan issues related to credentialing, claims, eligibility, disease management, utilization management, quality and risk adjustment programs
- Collaborates with Executive Director and Lead Physician to conduct provider meetings to share and discuss economic data, identify and support best practices and escalates discrepancies for resolution, as needed
- Works with Executive Directors on all required PBM provider meetings. The PBM is responsible for the agenda, minutes of the meeting, any action items and information reported appropriately
- Collaborates with contracting team and payers to ensure provider data is correct and Provider directories include any needed updates. Completes Practitioner Data Forms and Provider Change Forms as needed
- Performs all other related duties as assigned
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
- Bachelor's degree Healthcare or Business Administration or a related field required
- Three or more years of provider relations or managed care experience
- Exceptional interpersonal skills with ability to interface effectively both internally and externally with a wide range of people including physicians, office staff, hospital executives and other health plan staff
- Excellent analytical and problem solving skills with effective follow through
- Strong verbal and written communication skills
- Solid knowledge of local provider community
- Masters Degree with a significant understanding of medical care financing and delivery systems, provider contracting, reimbursement arrangements and network management
- Presentation skills to small and large groups
- Professional provider relations experience involving physicians and administrative staff
- Provider recruitment and contracting experience
- Ability to travel overnight
- Ability to lift up to 25 pounds
- Ability to push or pull heavy objects using up to pounds of force
- Ability to sit for extended periods of time
- Ability to stand for extended periods of time
- Ability to use fine motor skills to operate office equipment and/or machinery
- Ability to properly drive and operate a company vehicle
- Ability to receive and comprehend instructions verbally and/or in writing
- Ability to use logical reasoning for simple and complex problem solving
Opportunities with American Health Network, part of Optum. When you join American Health Network (AHN), you become part of a team that strives to identify and retain the top healthcare professionals in the markets it serves. At American Health Network, we want to be the best health care organization we can be. Our mission is to improve the health of our patients. We're a physician-led organization, operating over 70 medical offices in Indiana and Ohio, with over 300 providers and 1200 employees. We're also part of Optum, in the UnitedHealth Group family of businesses, and backed by the resources of a global health care organization working to help people live healthier lives and help make the health system work better for everyone. That's an important differentiator as more people need our help simplifying the complexities of the American health care system. At the same time, the culture of AHN supports work-life flexibility for employees and places a high value on their physical, emotional, financial and other aspects of well-being.
*All Telecommuters will be required to adhere to UnitedHealth Group's Telecommuter Policy
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.
Job Keywords: Physician Business Manager, PBM, Provider recruiter, provider relations, medicare advantage, value-based care, American Health Network, AHN, Optum, OptumCare, Central Indiana, Indianapolis, IN, Indiana, Telecommute, Telecommuter, Telecommuting, Work from home, Work at home, Remote
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