UPMC Health Plan is seeking a Physician Account Executive to support the National Network Management Department. This position will predominantly be working from home and must be based in Pennsylvania. Occasional travel throughout the state may be required to meet with providers or attend conferences.
This role will manage relationships with LTSS providers within the UPMC Health Plan service area. Provide assistance and support to other assigned LTSS providers and their staff enabling them to resolve daily operational issues, as necessary. Evaluate the effectiveness of the LTSS providers’ clinical and operational processes and assist the practice in developing action plans and identifying resources to impact change. Work with a broad spectrum of UPMC Health Plan personnel, network providers, and external resources to complete all tasks related to network management projects, goals and objectives.

• Assist in development of plans, by market segment to increase UPMC Health Plan patient base with key accounts. Determine provider role in these activities.
• Meet with targeted physician practices to assess practice patterns and make recommendations to improve provider performance.
• Monitor ongoing performance of practices and report findings to physicians to help improve clinical and operational performance.
• Provide information on plan resources to assist.
• Create and lead team to impact change.
• Assist Manager in coordination of staff development and training. Mentor by accompanying Network Managers to appointments when needed.
• Manage relationships with key high volume accounts within the UPMC Health Plan physician network.
• Track and document success and report results to practice and to management.
• Distribute provider reports, lead development and implementation of action plans.
• Manage special projects assigned by manager and department director.
• Identify, document and distribute best practice information.
• Meet deadlines and turnaround times set by manager and department director (these deadlines and turnaround times will, at times, require the employee to work until the project is completed, meaning extended daily work hours, extended work weeks, or both).
• B.A. degree in business, health care, finance, or related field or 5 years of experience in managed care/physician office setting required.
• Prior experience with LTSS Providers, claims, or home-health strongly preferred.
• Drivers license and own vehicle strongly preferred.
• Excellent verbal and written communication skills, analytical and organizational skills are required.
• Extensive problem solving experience is required.
• Presentation experience and experience working with physicians.
• Goal-oriented and have experience with development and implementation of action plans.
• Leadership skills are desired.
• Excellent project management, analytical, organizational, and customer service skills are required.
• Ability to work within an aggressive service-based environment.
• Ability to continuously interact effectively with all Health Plan departments is critical.
• Ability to effectively manage relationships with assigned strategic practices and keep accurate records of all activity for reporting purposes.
• Ability to develop and analyze focused action plans for key accounts.
• Minimal direction required.
• Ability to present information to management in a clear and professional manner.
• Results-oriented and self-motivated.LICENSURE, CERTIFICATIONS, AND CLEARANCES:UPMC is an Equal Opportunity Employer/Disability/Veteran