COVID-19 Vaccination Information

Across UPMC, our guiding principle is to always prioritize the safety of our employees, patients, and members. UPMC believes that vaccination is important, helps protect all, and advocates that everyone who can be vaccinated should be vaccinated.

UPMC complies with all governmental requirements related to local, state, and federal COVID-19 vaccination for employment. The Jan. 13 Supreme Court of the United States decision that the Centers for Medicare & Medicaid Services federal COVID-19 vaccine mandate will move forward requires UPMC to ensure employees either get vaccinated or receive a requested medical or religious exemption.

If you are not yet vaccinated, we urge you to get a vaccine now. You can schedule your COVID-19 vaccination through UPMC or visit a non-UPMC provider or UPMC Urgent Care location.

Proof of vaccination is not required upon hire; however, employees will be responsible for ensuring post-hire compliance by getting vaccinated or requesting a medical or religious exemption.

For more information about UPMC’s response to COVID-19, please visit UPMC.com/coronavirus.

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Compliance Administrator CHIP- Exchange Compliance- Pittsburgh, PA

  • Job ID: 750529442
  • Status: Full-Time
  • Regular/Temporary: Regular
  • Hours:
  • Shift: Day Job
  • Facility: UPMC Health Plan
  • Department: Exchange Compliance
  • Location: 600 Grant St, Pittsburgh PA 15219
  • Union Position: No
  • Salary Range: $31.08 to $52.46 / hour

Description

UPMC has an exciting opportunity for a Compliance Administrator CHIP position the the Exchange Compliance department.  This is a full time position working Monday through Friday 8:30 a.m. to 5:00 p.m.  This position will be a hybrid of working from home and in ofice occasionally which will bel ocated in the US Steel Tower in downtown Pittsburgh.  

Position incumbent will work with various UPMC Health Plan departments to successfully help support their activities as they relate to understanding and operationalizing Federal and State regulatory requirements for CHIP Products and Exchange Marketplace Products as needed.

Responsibilities:

CHIP Compliance:

  • Serve as a liaison to Pennsylvania's Department of Human Services (DHS) for communicating and disseminating CHIP contractual requirements to health plan operational stakeholders.
  • Coordinate participation of various UPMC Health Plan subject matter experts in periodic DHS meetings impacting the health plan's ability to comply with the CHIP program requirements. Monitor operational processes against DHS requirements and standards.
  • Research for best practices, evaluate for trends, assist in development of efficient workflows and monitor any action plans.
  • Track the submission of reports as required by the terms of our CHIP contract (e.g., fraud/abuse, marketing/outreach, HEDIS, CAHPS).
  • Work with various operations teams to support preparing state regulatory filings while collaborating with other health plan departments on service area expansion proposals.
  • Work with internal Health Plan stakeholders to identify opportunities, evaluate depth of current audits and recommend enhancements that align with compliance objectives.
  • Review Health Plan policies for impact on the CHIP product and assist in the development of CHIP-specific policies.
  • Responsible for coordinating various tasks related to the delegated and downstream entity (vendor oversight) process.
  • Prepare regular management and/or Board reports and presentations.

Exchange:

  • Monitor for new guidance from Health and Human Services (HHS) and other regulatory entities regarding the Affordable Care Act and other pertinent legislation.
  • Assist with the Qualified Health Plan (QHP) regulatory product filing submission, resubmission, and correction notice responses.
  • Perfomrs in accordance with system-wide competencies/behaviors.
  • Perfomrs other duties as assigned.

 

Qualifications

  • Bachelor's Degree required.
  • Relevant graduate degree in a related field preferred, but not required.
  • Minimum of 4 years of demonstrated and progressively increasing experience/knowledge of healthcare regulatory compliance required.
  • Strong preference for substantive CHIP and/or Exchange compliance experience.
  • Excellent organizational capabilities with ability to work effectively as a team player.
  • Ability to continuously interact effectively and professionally with all levels of staff.
  • Excellent written and oral communication skills.
  • Ability to handle multiple priorities/projects in a fast-paced professional environment.
  • Working knowledge of word-processing and database software.
  • Demonstrated performance in meeting time-sensitive deadlines with minimal supervision.
  • Business minded partner and collaborator who continually builds relationships, consensus and coalitions to get things done.
  • Strong emotional intelligence and self-awareness.


Licensure, Certifications, and Clearances:

UPMC is an Equal Opportunity Employer/Disability/Veteran

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   Current UPMC employees must apply in HR Direct

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