Job Description

Job Title: Mgr, Shared Savings Quality
Job ID: 714063
Status: Full-Time
Regular/Temporary: Regular
Hours:
Shift: Day Job
Facility: UPMC Health Plan
Department: Network Management
Location: 600 Grant St, Pittsburgh PA 15219

Description

Purpose:
Under the general direction of the Director of Quality & Value-Based Reimbursement, the Manager of Shared Savings will be responsible for developing a quality reporting structure, the goal of which is to provide Value-Based Reimbursement Partners with tailored and actionable quality reporting. This individual is responsible for comprehensive analysis of data and information for Quality-related work including production of provider quality profiles.

 

The Manager takes a leadership role in the development, enhancement, documentation, and communication of the evaluation of quality and other programs. The Manager also takes a leadership role in the development and oversight of all quality analysis and reporting activities including staff development and processes related to department goals.

 

To successfully perform the role, the Manager must understand report design and statistical analysis as well as the causes of clinical trends and anomalies in data.

Responsibilities:

  • Continually strive to ensure that Shared Savings Partners' feedback, ideas and concerns are relayed to appropriate HP personnel and taken into consideration when developing reports.
  • Design and perform reports and statistical analyses, and then be able to explain this analysis to a non-technical audience of both internal and external customers including senior management.
  • Develop a structure to support ongoing quality-related analytics for Value-Based Reimbursement Partners.
  • Maintain a close working relationship and represent the Shared Savings team with all internal Health Plan departments who directly/indirectly affect SS reporting and program structure.
  • Manage routine & special projects which may require oversight of other departments' work and coordination of a wide variety of functions
  • Meet deadlines and turnaround times set by the department Director and Senior Director
  • Monitor program results against appropriate benchmarks.

Qualifications

  • B.S. degree in business, health care, management or a related field is required. Masters is preferred.
  • Seven to ten years of applicable experience in health care insurance or health care industry is required.
  • Management/Leadership experience required.
  • Demonstrated ability to work in a matrixed environment and to manage internal interdisciplinary team as well as diverse external stakeholders.
  • Demonstrated strong ability to forge strong interpersonal relationships within the department, with other departments, and with the physician network.
  • Excellent planning, communications, documentation, organizational, analytical, and problem-solving abilities are required.
  • Ability to interpret and summarize results of various analyses in a timely and meaningful way.
  • Ability to re-engineer processes to positively impact the performance of the department and the Health Plan, as well as individual provider offices.
  • Ability to analyze financial & clinical results and to comprehend forecasting models.
  • Ability to react to various needs and to resolve operational issues related to both internal and external customers in a timely & efficient manner.
  • Ability to direct staff with minimal amount of supervision.
  • Excellent leadership skills.
  • Excellent organizational, interpersonal and communication skills.
  • Excellent presentation skills, ability to effectively lead meetings.

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

Salary Range: $33.94 to $57.47

Union Position: No

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