UPMC Health Plan is looking to solve the problem of clinically integrating a Sales and Retention team and creating innovative employer clinical program initiatives, while also developing leading-edge Health Plan clinical strategies for employer engagement.
Requirements
- Doctor of Medicine or Doctor of Osteopathy from an accredited school.
- Pennsylvania Medical License
- Experience managing commercial plans
- 5-10 years of clinical experience in any specialty
Responsibilities
- As a clinical ‘thought leader’ and UPMC Health Plan physician liaison, participate in the creation of opportunities to consult, interact and elicit feedback with the physician community, then act upon this valuable information, raising proactive clinical intervention to unprecedented levels.
- Collaborate with AVP of Commercial Products and CMO of Clinical Operations and Commercial Products, as well as Commercial Line of Business leadership to engage all functional areas of the Health Plan from a clinical perspective, developing innovative approaches for the advancement of the Commercial product lines;
- Collaborate with the Chief Medical Officer, ISD, and executive clinical leadership to develop unique partnerships and differentiated relationships with current and prospective employer groups, consultants and brokers, in order to understand and meet their health and welfare needs.
- Interface with UPMC Health System cross-functional and shared resources to further the ’cause’ to create a seamless healthcare patient-flow management process and insurance model based on the needs of the Commercial line of business.
- Motivate and mentor UPMC Health Plan’s clinical Commercial staff by ‘setting the pace’ and fostering ‘excellence by example’.
- Serve as an integral part in the design and implementation of medical management initiatives such as disease management to improve quality and cost effectiveness of care delivered to Commercial members.
- Swiftly respond to challenges and/or opportunities as they arise. Develop and implement innovative programs to act on historical data, identifying new trends, retooling existing approaches, and analyzing the competition.
Other
- Performs in accordance with system-wide competencies/behaviors.
- Performs other duties as assigned.
- As an integral member of UPMC Health Plan’s leadership team, serve as a ‘role model’ and ‘health advocate’ within the Western Pennsylvania community, including active participation with UPMC sponsored activities, public events and community outreach programs.
- Nurture personal and professional growth/development by attending seminars, workshops, and establishing professional affiliations to keep abreast of latest trends in field of expertise.
- Assess the overall employer focused team with clinical leadership, including ongoing recruitment and hiring of talent.
