1+ months

PSU Business Manager - Houston, TX - 927214

Houston, TX 77002
Apply Now
Apply on the Company Site
  • Job Code
    927214

Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your lifes best work.(sm)
"
"The purpose of this position is to support contracted physician management objectives through participation in design, development and tactical implementation of strategic business objectives for successful retention, management and growth of the WellMed contracted primary care, specialty care and ancillary provider network. These initiatives should result in the contracted network being able to understand and support the vision to change the face of healthcare delivery for seniors. This will drive the financial viability of the market and provide a full continuum of care for the members. The responsibilities of this position demand a wide range of capabilities including: strategic planning and analysis skills; strong understanding of billing and collections for physicians and or medical practices; accounting knowledge and understanding of financial statements; understanding of managed care contracts; understanding of HEDIS and HCC coding; management breadth to direct and motivate; highly developed communication skills; and the ability to develop clear action plans and drive process, given often ambiguous issues with numerous interdependencies. This position will facilitate any unresolved issues that remain as a result from following the standard process.
"
"Primary Responsibilities:

""
    ""
  • Manages Scheduling staff and Auditing staff and is responsible for the overall success of the markets network of physicians (contracted providers, affliated providers and Moonshot providers)
  • ""
  • Responsible for all aspects of staff development to include hiring, training, coaching and development
  • ""
  • Maximizes staff performance and technical expertise through clearly defined objectives, training, skill development and leadership to ensure quality services to all customers
  • ""
  • Delegate, monitor and control work progress on key metrics, initiatives / action plans, staff productivity, and administrative expenses
  • ""
  • Participates in development and implementation of systems that support Houston Market operations
  • ""
  • Maintains effective network support services by working effectively with the Medical Director, Market Medical Director, Regional Team, Clinic Operations, Houston PSU operations and other corporate departments
  • ""
  • Handles complex and/or difficult provider inquires and/or problems and facilitates resolution of provider issues in relationship to Quality metrics, quality screenigs, Focus on Care Screenings. Continuously strive to ensure that favorable relationships are maintained while ensuring the interest of the organization
  • ""
  • Takes ownership of total work process and provides constructive information to ensure physician partners have support to meet initiatives
  • ""
  • Analyzes data while collaborating and/or participating in discussions with colleagues and business partners to identify potential root cause of issues
  • ""
  • Demonstrate understanding of providers' business goals and strategies in order to facilitate the analysis and resolution of their issues
  • ""
  • Work with relevant internal stakeholders to identify obstacles and barriers identified by providers, and methods for removing them
  • ""
  • Communicate and advocate providers' needs to internal stakeholders in order to drive creation of solutions that meet our mutual business goals
  • ""
  • Communicate industry and company information to providers through various means (e.g., newsletters; emails; outreach calls; teleconference; conferences; on-site meetings)
  • ""
  • Develops and coaches staff to facilitate strategic planning for scheduling and working with physician groups and their staff for completion of physician metrics
  • ""
  • Assists with and manages business projections, forecasting and budgets, both financially and with timelines, for assigned projects
  • ""
  • Guides, oversees and ensures competency of the scheduling and auditing staff
  • ""
  • Assist corporate education team and provides input on tools used to education for team staff
  • ""
  • Ensures all education objectives are being met, both on a formal and ad-hoc basis
  • ""
  • Responsible for ensuring the staff is responding to provider scheduling efforts, clinic schedules
  • ""
  • Resolving provider and/or clinic issues on a daily basis. Facilitates provider and staff discussions and assists in negotiating resolution to escalated provider issues with the capability to determine if/when issues require escalation
  • ""
  • Collectively works with Care Management leadership to create, maintain, implement and evaluate business strategic plans on HEDIS and Quality metrics that positively impact total medical costs
  • ""
  • Works closely with Corporate Sales & Marketing, Quality Practice Support Unit, DataRAPS and Quality departments to attain metric targets by collaboratively creating, maintaining, implementing and evaluating business strategic plans for each area
  • ""
  • Overall responsibility for the selection of clinics for the Houston network. This includes creation of strategic plan, training of the staff, working with team coordinators, Clinical Manager and Leadership to carrry out the strategic plan, negotiation of the contract as well as overall implementation of new primary care provider groups
  • ""
  • Understands payer relationships within market and ensures any operational issues are visible to the appropriate parties and ensures issue resolution
  • ""
  • Performs all other related duties as assigned
  • "
""

Youll 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.

"

Required Qualifications:

""
    ""
  • Bachelors degree (4+ years of comparable work experience beyond the required years of experience may be substituted in lieu of a bachelors degree)
  • ""
  • 5+ years of related experience in network development/provider relations with 3+ years with management experience
  • ""
  • Sound working knowledge of Medicare health care operations including HEDIS, HCC Coding and Medicare Advantage
  • ""
  • Knowledge of state and federal laws relating to Medicare
  • ""
  • Reliable transportation and ability and willingness to travel throughout the area regularly
  • ""
  • You will be asked to perform this role in an office setting or other company location, however, may be required to work from home temporarily due to space limitations
  • ""
  • Employees are required to screen for symptoms using the ProtectWell mobile app, Interactive Voice Response (i.e., entering your symptoms via phone system) or a similar UnitedHealth Group-approved symptom screener prior to entering the work site each day, in order to keep our work sites safe. Employees must comply with any state and local masking orders. In addition, when in a UnitedHealth Group building, employees are expected to wear a mask in areas where physical distancing cannot be attained
  • "
""

Preferred Qualifications:

""
    ""
  • Masters degree
  • ""
  • 5+ years of in a healthcare related field
  • ""
  • 3+ years of Healthcare management experience
  • "
""

""

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)

""

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: Business, Manager, Houston, TX, Texas

Posted: 2021-04-23 Expires: 2021-06-21

UnitedHealth Group is the most diversified health care company in the United States and a leader worldwide in helping people live healthier lives and helping to make the health system work better for everyone.

Sponsored by:
ADP Logo

Before you go...

Our free job seeker tools include alerts for new jobs, saving your favorites, optimized job matching, and more! Just enter your email below.

Share this job:

PSU Business Manager - Houston, TX - 927214

UnitedHealth Group
Houston, TX 77002

Join us to start saving your Favorite Jobs!

Sign In Create Account
Powered ByCareerCast