UPMC Health Plan is hiring a Provider Account Executive four our Dental, Vision, Ancillary department. This is a hybrid role with 50-75% travel to providers in the surrounding areas. In this role you will manage relationships with strategic high volume Ancillary (Dental and Vision) practices within the UPMC Health Plan service area. You will provide assistance and support to all assigned provider practices and its staff enabling them to resolve daily operational issues, as necessary. In this role you will evaluate the effectiveness of provider practice clinical and operational processes and assist the practice in developing action plans and identifying resources to impact change. You will present reports to providers and staff and lead a team of professionals, who will be instrumental in the improvement of patient outcomes, member satisfaction and cost control. In addition, you will 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.

Responsibilities:

• Assist Manager in coordination of staff development and training. Mentor by accompanying Network Managers to appointments when needed.
• 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).
• Assist in development of plans, by market segment to increase UPMC Dental and Vision Advantage patient base with key accounts. Determine provider role in these activities.
• Monitor ongoing performance of practices and report findings to providers to help improve clinical and operational performance.
• Lead recruitment efforts to meet the needs of network expansion
• Provide information on plan resources to assist.
• Meet with targeted provider practices to assess practice patterns and make recommendations to improve provider performance.
• Track and document success and report results to practice and to management.
• Distribute provider reports, lead development and implementation of action plans.
• Manage relationships with key high volume accounts within the UPMC Dental and Vision Advantage network.

• B.A. degree in business, health care, finance, or related field or 5 years of experience in managed care/physician office setting required.
• Excellent verbal and written communication skills, and analytical and organizational skills are required.
• Extensive problem-solving experience is required.
• Presentation experience and experience working with providers.
• Goal-oriented and have experience with the 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 is required.
• Ability to present information to management in a clear and professional manner.
• Results-oriented and self-motivated.
• Candidates should have a valid license and reliable transportation.

  Licensure, Certifications, and Clearances:

  UPMC is an Equal Opportunity Employer/Disability/Veteran