Job Description

Job Title: HCBS Provider Monitoring Specialist - Associate
Job ID: 658513
Status: Full-Time
Regular/Temporary: Regular
Hours:
Shift: Day Job
Facility: UPMC Health Plan
Department: Community HealthChoices
Location: 600 Grant St, Pittsburgh PA 15219

Description

Community HealthChoices (CHC) is Pennsylvania's managed care long term services and supports (LTSS) program serving seniors and individuals with physical disabilities in the Commonwealth who are covered by Medicare and Medicaid.

This position supports Home and Community Based Service Providers (HCBS) in gaining operational efficiencies by identifying and addressing process improvement opportunities. This position also performs on-going monitoring to ensure provider compliance with both internal UPMC and governmental regulatory requirements.

Responsibilities:
  • Ability to explain results of findings to internal and external stakeholders.
  • Communicate effectively and regularly with other team members, management, and applicable stakeholders.
  • Effectively prioritize and complete all assigned tasks.
  • Generate accurate and detailed reports for effective monitoring, trending, and analysis.
  • Identify areas of concern or provider deficiencies through data analysis and propose solutions based on findings and established protocols.
  • Successfully manage assigned projects and initiatives

Qualifications

  • Bachelors Degree and/or equivalent education or work experience
  • 2 years general business experience required

Licensure, Certifications, and Clearances:

PMC is an equal opportunity employer. Minority/Females/Veterans/Individuals with Disabilities

Salary Range: $22.60 to $39.11

Union Position: No

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