Physician Business Consultant - San Antonio, TX

Careers at UnitedHealth Group

We're creating opportunities in every corner of the health care marketplace to improve lives while we're building careers. At UnitedHealth Group, we support you with the latest tools, advanced training and the combined strength of high caliber co-workers who share your passion, your energy and your commitment to quality. Join us and start doing your life's best work. SM


Compassion. It's the starting point for health care providers like you and it's what drives us every day as we put our exceptional skills together with a real feeling of caring for others. This is a place where your impact goes beyond providing care one patient at a time. Because here, every day, you're also providing leadership and contributing in ways that can affect millions for years to come. Ready for a new path? Learn more, and start doing your life's best work. SM

Our teams are helping people from around the world. We can bring out your best as you put your listening, analytical and problem solving skills to work in a setting that is geared to helping improve lives and enhance health care for millions. Here, you'll discover a wealth of pathways for professional growth within Customer Service, Billing, Claims, Enrollment & Eligibility and across our global economy. Join us and find out why this is the place to do your life's best work. SM

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 life's best work.(sm)

The Physician Business Consultant (PBC) researches and investigates critical business problems through quantitative analyses of revenue, utilization metrics, healthcare costs, membership trends, and quality and risk adjustment data. The PBC provides management with statistical findings and conclusions and partners with stakeholders to identify areas of opportunity to improve the financial performance of clinics and risk pools. PBC's also develop recommendations and strategies and communicates findings to leadership and operations teams to help implement corrective action plans.

Primary Responsibilities:
  • Demonstrate understanding of a provider's business goals, contracting, performance metrics/scorecard, industry trends, and WellMed business model
  • Coaches and provides the translation of financial data to guide action
  • Assist with contracted and affiliated efforts
    • Market contracting strategy
    • Assist PBMs with financial education, meeting presentations, and identifying areas of opportunities
    • Corrective action plan for pools
    • Analysis of yearly contracted pool structure
      • Pool movement and restructuring impact
      • Compliance of pool criteria and structure
  • Monitors and reviews metric performance for Hospital and Specialty Joint Operating Committees (JOC).
  • Conduct financial and HCE training for new providers and staff
  • Partner with market dyads on market-wide initiatives
  • Act as SME over market financials and support leadership on strategic projects and decisions
  • Develop tracking metrics and perform analysis of special projects
  • Monthly or weekly report card/analysis packet
  • Support market meetings: Strategic meetings, Contracted Pool meetings, and Monthly Market Success meetings (MSM) and/or Grand Rounds (GR)
  • Performs all other related duties as assigned

You'll 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:
  • Bachelor's Degree in Finance, Accounting, Business Administration, Healthcare Administration, or related field (4 additional years of comparable work experience beyond the required years of experience may be substituted in lieu of a bachelor's degree)
  • 3+ years of general healthcare data analysis experience
  • 2+ years of experience in a reporting and analytical role
  • Understanding of the complexity of Member healthcare, claims
  • Knowledge of Managed Care and Medicare programs
  • Ability to communicate and facilitate strategic meetings with groups of all sizes
  • Ability to conduct performance evaluation to identify performance measures or indicators and the actions needed to improve or correct performance, relative to the goals
  • Proficient in MS Excel and/or equivalent data capture/reporting tools
  • Ability to travel up to 75% within assigned market
  • Full COVID-19 vaccination is an essential requirement of this role. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination prior to employment to ensure compliance

Preferred Qualifications:
  • Risk Adjustment knowledge related to CMS reimbursement models
  • 3+ years of experience in a clinical setting
  • Ability to act as a mentor to others
  • Solid verbal and written communication skills
  • Ability to work independently, use good judgment and decision making process

Physical & Mental Requirements:
  • Ability to lift up to 25 pounds
  • Ability to push or pull heavy objects using up to 25 pounds of force
  • Ability to sit for extended periods of time
  • Ability to use fine motor skills to operate office equipment and/or machinery
  • Ability to receive and comprehend instructions verbally and/or in writing
  • Ability to use logical reasoning for simple and complex problem solving

UnitedHealth Group requires all new hires and employees to report their COVID-19 vaccination status.

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 550,000+ 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: 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: Physician Business Consultant, San Antonio, TX, Texas