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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   Current UPMC employees must apply in HR Direct

Clinical Manager, Revenue Cycle CCM

  • Job ID: 886849400
  • Status: Full-Time
  • Regular/Temporary: Regular
  • Hours:
  • Shift: Day Job
  • Facility: Corporate Revenue Cycle
  • Department: Rev Cyc Care Mgmt
  • Location: 2 Hot Metal Street, Pittsburgh PA 15203
  • Union Position: No
  • Salary Range: $34.88 to $59.53 / hour

Description

Purpose:

 

UPMC Corporate Revenue Cycle is hiring a Clinical Manager to join our Care Management Team!  This role works Monday through Friday during daylight hours (primarily 8:00am until 4:30pm).   The position has the opportunity to work remotely.

The Clinical Manager is responsible for the direct oversight of the day-to-day operations of the authorization, denial management, and/or utilization review functions of UPMC Revenue Cycle, involving both clinical and non-clinical staff.  The role will also ensure that department operations are functioning optimally, and work distribution and workflow processes are operating efficiently and in accordance with all regulatory guidelines.  Additionally, this employee will be responsible for staff development, as well as team attainment of quality and productivity goals.

Do you have care management or revenue cycle experience?  If so, this could be the next step in your career.  Read on and apply today!

Responsibilities:

  • Analyze data for trends and causative factors that promote or impede progression toward expected outcomes. Communicates identified trends to appropriate leadership.
  • Aggressively manage Denial and Edit resolution processes and make improvements to minimize or eliminate.
  • Develop a high-performing team by identifying opportunities to enhance their knowledge and skills, providing training and mentoring, and promoting a collaborative team-focused work environment.
  • Utilize the core values as the basis for management making them part of the recruitment, orientation and training for associates (respect, simplicity, integrity, inventiveness and customer services advocacy.)
  • Prioritize work assignments as needed and adjust staffing to accommodate work volumes; provide guidance and assistance to staff in the completion of difficult duties/responsibilities and resolution of complex issues.
  • Monitor and support daily staff functions by establishing, maintaining and modifying work standards and productivity/quality tools in all areas related to scope of the Manager's responsibility.
  • Ensure that all policies, procedures, job descriptions, reports and other documentation are properly maintained and issues addressed as required.
  • Complete or direct the completion of all necessary human resource documentation and adhere to all human resources expectations.
  • Assist in the implementation and modification/creation of software to support areas related to scope of responsibility.
  • Function as a resource person for authorization, denial management and/or utilization review processes.
  • Assess and respond to organizational and customer needs with innovative programs to ensure customer satisfaction.
  • Communicate regularly and effectively with subordinates and superiors, regarding the status and condition of the business operation under control of the Manager.
  • Perform other duties as assigned.

 

Qualifications

  • Bachelor's degree in Nursing or other Healthcare related field required.
  • Pennsylvania State Nursing Licensure required.
  • Five (5) years' experience in revenue cycle/care management/program development required.
  • Previous supervisory or management experience preferred.
  • Ability to build credible and effective relationships with physician leadership.
  • Strong analytical skills.
  • Proficient in Microsoft Office Applications and analytical/reporting tools.
  • Keen understanding of clinical and revenue cycle processes.
  • Excellent communication and interpersonal skills.
  • Demonstrated leadership capabilities.
  • Strong quality/process improvement expertise.
  • Managed care and third-party payor experience (preferred).
  • Denial Management experience (preferred).
  • Understanding of clinical and authorization/utilization review processes (preferred).

Licensure, Certifications, and Clearances:

  • Pennsylvania State Nursing Licensure required

UPMC is an Equal Opportunity Employer/Disability/Veteran

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More than just competitive pay and benefits, UPMC’s Total Rewards package cares for you in all areas of life — because we believe that you’re at your best when receiving the support you need: professional, personal, financial, and more.

Our Values

At UPMC, we’re driven by shared values that guide our work and keep us accountable to one another. Our Values of Quality & Safety, Dignity & Respect, Caring & Listening, Responsibility & Integrity, Excellence & Innovation play a vital role in creating a cohesive, positive experience for our employees, patients, health plan members, and community. Ready to join us? Apply today.

   Current UPMC employees must apply in HR Direct

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