Physician Account Executive (providers)

Provider Account Executive

Are you passionate about building strong relationships and improving healthcare quality? UPMC Health Plan is looking for a Provider Account Executive to join our team and make a meaningful impact in Western PA.

This is a full-time hybrid role that combines office collaboration (3 days per week) with travel to provider sites—perfect for someone who thrives on variety and connection!

What You'll DoAs a Provider Account Executive, you'll be the trusted partner for Home and Community-Based Service (HCBS) providers. Your mission? Help providers deliver the best possible care by offering education, support, and solutions. You'll work closely with internal teams and external partners to ensure compliance, resolve issues, and drive quality improvements.

Here's what your role will include:

• Build strong partnerships: Meet with providers to review compliance, update information, and share best practices.

• Drive quality and compliance: Monitor provider performance and provide education to improve outcomes.

• Be the go-to resource: Assist with claims, billing, authorizations, and regulatory questions.

• Lead initiatives: Manage special projects, recruit and onboard new providers, and support training efforts.

• Collaborate across teams: Act as a liaison between providers and key UPMC departments like Service Coordination, Provider Monitoring, and Claims.

• Problem-solve with impact: Help providers develop action plans and ensure submission of compliance-related correction plans.

What We're Looking For• Strong relationship-building and communication skills.

• Ability to manage multiple priorities and meet deadlines.

• Experience in provider relations, healthcare compliance, or network management is a plus.

• Willingness to travel within the Western PA and work in a hybrid schedule.

Why UPMC Health Plan?• A collaborative, mission-driven environment.

• Opportunities to make a real difference in provider performance and patient care.

• Professional growth and development within a leading healthcare organization.

Ready to take the next step in your career? Apply today and help us strengthen provider partnerships and improve healthcare quality across Pennsylvania.

• 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, 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