Job Description

Job Title: Operations Analyst, Associate -Operations Excellence
Job ID: 668217
Status: Full-Time
Regular/Temporary: Regular
Shift: Day Job
Facility: UPMC Health Plan
Department: Operations Support
Location: 339 Sixth Avenue, Pittsburgh PA 15222


Are you a health insurance professional with claims processing experience?  If so, an opportunity as an Operations Analyst, Associate with UPMC Health Plan's Claims Operations team may be the perfect fit for you.  This role oversees administrative, system processes and special projects as they relate to the identification, implementation and maintenance of the claims transactional system for all UPMC Health Plan products. Under the general direction of Business Support Management, this role will analyze, identify, propose and implement solutions for all business areas. Additionally, this role acts as subject matter expert supporting all areas, and interact with staff to answer questions and resolve issues as they arise.

  • Assists other departments during periods of backlogs
  • Completes Executive Summary management documentation as required
  • Completes inquiries generated from the data reporting and analysis area
  • Effectively prioritize and complete all assigned tasks
  • Identify areas of concern that may compromise client satisfaction through data analysis, and propose solutions based on findings, expertise, and research
  • Identify, administer, test, audit, and implement new processes on transactional claims systems
  • Interface with customers by telephone, correspondence, and or in person to answer inquiries and resolve concerns/issues
  • Maintains employee/insured confidentiality
  • Manages, updates, and maintains source data dictionaries as they relate to processes
  • Model business requirements for new systems, special projects and enhancements to existing systems; validate and test fixes/enhancements to new and existing systems
  • Openly participate in team meetings, provide ideas and suggestions to ensure client satisfaction, and promote teamwork
  • Participates in training programs when available/as requested
  • Performs in accordance with system-wide competencies/behaviors
  • Performs other duties as assigned


  • Bachelor's Degree or equivalent work experience
  • Minimum two years general business experience
  • Experience in health care insurance or health care industry preferred, but those with relevant experience in other industries will be considered  
  • Knowledge of Commercial, Medicaid, Medicare and Individual products preferred
  • Competence in MS Office required, including MSExcel, MSAccess, MSWord
  • Excellent planning communication, documentation, analytical and problem solving abilities
  • Ability to work in a fast-paced environment
  • Must possess strong interpersonal, organizational, and project management skills, with the ability to work on multiple tasks simultaneously

Licensure, Certifications, and Clearances:
UPMC is an equal opportunity employer. Minority/Females/Veterans/Individuals with Disabilities

Salary Range: $20.60 to $35.57

Union Position: No

At UPMC, our shared goal is to create a cohesive, positive, experience for our employees, patients, health plan members, and community. If you too are driven by these values, you may be a great fit at UPMC!


UPMC provides a total rewards package that can help you achieve the goals you have for your career and your personal life. Whether you want to learn a new skill through a training course, reach personal health and wellness targets, become more involved in your community, or follow a career path that provides you with the right experience to be successful, UPMC can help you get to where you want to be.

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