Senior Physician Business Manager - Polk County, FL - Full-time / Part-time

Expanding access to affordable, high quality health care starts here. This is where some of the most innovative ideas in health care are created every day. This is where bold people with big ideas are writing the next chapter in health care. This is the place to do your life's best work.(sm)
This position functions as a subject matter expert in network operations. This position strives to bring consistency and experience to existing Physician Business Managers in the local market by analyzing, reviewing, forecasting, trending, and presenting information for operational and business planning. This position will sand organize and assist the local Physician Business Managers in achieving short and long term operational/strategic business goals/ by developing, enhancing and maintaining operational information and models. They also develop, in conjunction with the local Director/Manager, and implement effective/strategic business solutions through research and analysis of data and business processes.    
   
Primary Responsibilities:    


Analyzes risk pool and provider group performance to determine areas of focus or improvement opportunities
Develops strategies to align contracted provider groups with company initiatives, goals (revenue and expense) and quality outcomes
Create and develop action plans to achieve metrics in quality, coding and financial performance
Provides explanations and interpretations within area of expertise
Provides daily direction and guidance to existing local Physician Business Managers and acts as the subject matter expert for their assign area
Uses pertinent data and facts to identify and solve a range of problems through experience, research and collaboration
Assists local Physician Business Managers with investigating non-standard requests and problems
Prioritizes and organizes assigned workload of local Physician Business Managers is able to meet deadlines while delivering the best outcomes possible
Provides explanations, direction and information to others on topics within area of expertise
Strong analytical skills required to support, compile and report key information
Drive processes and technology improvement initiatives that directly impact Revenue, HEDIS/STAR measures and Quality Metrics, using standard project methodology (requirements, design, test, etc.)
Use data to identify trends, patterns and opportunities for the business and clients.  Develop business strategies in line with company strategic initiatives
Engage provider staff and providers in analysis and evaluation of functional models and process improvements; identify dependencies and priorities
Evaluate and drive processes, provider relationships and implementation plans
Produce, publish and distribute scheduled and ad-hoc client and operational reports relating to the development and performance of products
Collaborate with other Physician Business Manager- Area Leads to foster teamwork and build consistency throughout the market
Serves as a liaison to the health plan and all customers

Required Qualifications: 

HS Diploma or GED
5+ years' experience in the medical field or health plan setting
Knowledge of Managed Care and Medicare programs 
Experience presenting group presentations and training  
Proficiency in Microsoft Word, Excel and PowerPoint
Travel 50% of the time 
This position requires AHCA level II background checks (fingerprinting) by the state of FL for all clinicians that have face to face contact with members or employees who have access to confidential patient data and will require renewal every five years.

United States Citizenship
Ability to obtain favorable adjudication following submission of Department of Defense eQuip Form SF86
Preferred Qualifications: 

Undergraduate degree
Risk adjustment experience
Ability to work independently, use good judgment and decision making process 
Ability to conduct performance evaluation to identify performance measures or indicators and the actions needed to improve or correct performance, relative to the goals 
Ability to resolve complete problems and evaluate options to implement solutions
Ability to adopt quickly to change in an ever-changing environment
Ability to Develop Long Term Relationships 
Strong Work Ethic & Desire to Succeed 
Ability to sit down with medical groups of all sizes and develop joint action/work plans  
Excellent Oral and Written Communication Skills  
Strong business acumen, analytical, critical thinking, and persuasion skills
As a requirement of UnitedHealth Group's contract with the Department of Defense, this position requires U.S. citizenship and proof of favorable adjudication following submission of Department of Defense eQuip Form SF86, (the National Agency Check Legal and Credit or NACLC). Successful completion of the NACLC process is a requirement for continued employment in this role. NACLC processing will be initiated by our TRICARE Security Officer post-offer, and can take 3-6 months for a final decision communication from the Department of Defense. Candidates will be allowed to begin employment with UnitedHealth Group in this role based on an interim clearance, and final results will be communicated as they are received. Failure to obtain final NACLC approval will result in termination from this role.
 
 
Careers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 90,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.(sm)
Diversity creates a healthier atmosphere: 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. Certain positions are subject to random drug testing.
 
 
Job Keywords:  Senior Physician Business Manager, Business Manager, Healthcare, WellMed, Management, Polk County, FL, Florida, Plant City, Davenport, Lake Wales, Winter Haven, Bartow, Lakeland