Job Description

Job Title: Sr. Manager, Revenue Reporting - CHC (Statutory Reporting)
Job ID: 764166
Status: Full-Time
Regular/Temporary: Regular
Hours:
Shift: Day Job
Facility: UPMC Health Plan
Department: CHC Recertification
Location: 600 Grant St, Pittsburgh PA 15219

Description

Community HealthChoices (CHC) is Pennsylvania's managed care long term services and supports (LTSS) program serving seniors and individuals with physical disabilities in the Commonwealth who are covered by Medicare and Medicaid.

  
The Senior Manager will assist the CFO of Community HealthChoices (CHC)  with day-to-day oversight responsibilities of providing responsive and timely reporting, data analysis and operations support to guide the overall strategic direction of the CHC product.

Responsibilities:

 

  • Collaborate with management, analytical, operational staff and other key internal stakeholders to develop timely action plans to achieve developed strategic goals.
  • Conduct business in a professional manner with potential vendor relationships in this regard, and establish all budget expectations for this area with the CFO of CHC and other product leadership.
  • Develop regulatory knowledge to work directly with CHC leadership to meet regulatory financial reporting requirements, develop IT solutions, and dashboards for monitoring compliance and business objectives.
  • Develop strategic predictive modeling methods to better understand the various CHC sub-populations and efficient ways to manage and monitor their utilization habits.
  • Monitor operating performance against regional, national and international benchmarks. Work closely and coordinate departmental priorities with CHC management staff. Mentor and develop the department's analysts; develop skills and career goals.
  • Oversee all budget and financial/analytical reporting for the CHC line of business.
  • Partner with clinical leadership and management in analyzing utilization and medical trends to forecast budget and utilization patterns in order to maximize clinical and operational intervention opportunities.
  • Performs in accordance with system-wide competencies/behaviors. Performs other duties as assigned.
  • Provide key information to senior management in a timely and comprehensive manner.
  • Serve as principal Health Plan expert and go-to person on CHC budget reporting and data analysis.
  • Direct staff in the preparation of revenue and expenditure forecasting/statistical analysis, and other analysis and work to ensure all staff can provide key business recommendations based on the outcomes of their analysis.
  • Thoroughly develop, manage, maintain and monitor key business practices put in place to optimize revenue opportunities.
  • Work with CFO of CHC, and key leadership in other functional areas of the Health Plan (such as Network, Pharmacy, Provider Services, Member Services, Medical Management, etc.), analytical, and operational staff to analyze and identify key opportunities improving current business practices and determining ways to expand business platforms.

 

Qualifications

  • Bachelors Degree in accounting, business finance, statistics, mathematics, health care management or closely related discipline is required but relevant Masters Degree is strongly preferred.
  • Healthcare and financial certifications and operations-related training is preferred. 7-10 years of proven experience/knowledge of financial analysis, statutory reporting and program management is required.
  • Ten (10) years experience with Medicaid and/or Medicare managed care is preferred.
  • Excellent organizational and leadership capabilities with previous staff supervision experience.
  • Ability to continuously interact effectively and professionally with all levels of Health Plan staff.
  • Excellent written and verbal communication skills, including strong abilities to communicate complex data concisely to many different audiences.
  • Exceptional analytical and problem solving skills.
  • Ability to handle multiple priorities/projects in a fast-paced professional environment.
  • Proficient with all Microsoft Office products; working knowledge of word-processing and database software (SQL or SAS programming preferred) Demonstrated performance in meeting deadlines, particularly in matrixed environments.

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

Salary Range: $33.94 to $57.47 / hour

Union Position: No

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