Job Description

Job Title: Business Analyst - CHC
Job ID: 719160
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 Health Choices will impact more than 400,000 people statewide who are dually eligible for Medicare and Medicaid or receive Medicaid funded long-term services and supports (LTSS). Through Community HealthChoices (CHC), we will coordinate physical health care and LTSS to enhance the quality of life and independence for frail seniors and adults with disabilities in home and community based environments as well as in institutional settings.

The Business Analyst will work with users and developers to identify problems and propose solutions. Maintain project planning documents, prepare materials, write and distribute workflow, maintain UPMC systems portfolio (checklist).

Responsibilities:
  • Ability to analyze benefit administration issues to determine the need for and the scope of polices and procedures.
  • Assist other departments during periods of backlogs.
  • Develop administration policies and procedures or business recommendations to ensure uniform, cost effective claims administration practices that comply with the law, plan documents and other company policies.
  • Effectively prioritize and complete all assigned tasks.
  • Identify areas of concern that may compromise client satisfaction.
  • Maintain employee/insured confidentiality.
  • Maintain project planning, model business requirements for new systems and enhancements to existing systems.
  • Openly participate in team meetings, provide ideas and suggestions to ensure client satisfaction, and promote teamwork.
  • Participate in training programs as available/requested.
  • Work with users and developers to identify problems and propose solutions.

Qualifications

Bachelors degree or equivalent related work experience required. Minimum of two years of general business experience required. Minimum of two years of experience in business/industry specialty required. Knowledge of commercial, Medicaid, and Medicare products preferred. Competent in MS Office and PC skills preferred. Working knowledge of COB (Coordination of Benefits) preferred. Organizational, interpersonal, and communication skills required.

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

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