Job Description

Job Title: External Medical Operations Analyst, Associate (Northeast Crawford County)
Job ID: 19949424
Status: Full-Time
Regular/Temporary: Regular
Hours:
Shift: Day Job
Facility: UPMC Health Plan
Department: MEDICARE HCC
Location: 600 Grant St, Pittsburgh PA 15219

Description

***This position will require travel to Erie, Crawford and Venango counties on a regular basis***

 

UPMC Health Plan has an exciting opportunity for an External Medical Abstraction Operations Analyst, Associate (Northeast Crawford County) in its Medicare Risk Adjustment department. While this position is based out of the U.S. Steel Tower in downtown Pittsburgh, the ideal candidate would live in Northeast Crawford County and travel from home to these assigned areas on most days.

 

This position is responsible for supporting Risk Adjustment, Quality Improvement, and Organizational Initiatives through onsite and offsite medical record abstraction. The External Medical Abstraction Operations Analyst, Associate will locate, retrieve, and upload appropriate medical records from providers in their assigned area into the collection tool.

 

This position requires active communication and building relationships with contacts in hospitals and practices. The ideal candidate is a highly organized, professional, and self-directed individual.

 
Responsibilities:
  • Schedule and visit assigned provider locations within your designated area.
  • Develop positive working relationships with providers, nursing and administrative

  • staff while on-site.
  • Assist with training new hires through ride-alongs and on the job training

  • sessions.
  • Abstract health information from patients’ paper or electronic medical charts.

  • Enter abstracted data into the standard data collection tool.

  • Update the Provider Information database following each visit.

  • Performs other job duties as required by manager/supervisor.

  • Meet deadlines and turnaround times set by department manager and director.

  • Communicate, collaborate with the Risk Adjustment team.

  • Model business requirements for new systems, special projects and enhancements to existing systems; validate and test fixes/enhancements to new and existing systems.

  • Openly participate in team meetings, provide ideas and suggestions to ensure client satisfaction and promote teamwork.

  • Performs in accordance with system-wide competencies/behaviors.

  • Participates in training programs when available/as requested.

  • Effectively prioritize and complete all assigned tasks.

  • Assists other departments during periods of backlogs.

  • Maintains employee/insured confidentiality.

  • Medical Records abstraction experience is preferred.

  • Risk adjustment and HEDIS experience is preferred.

Qualifications

  • Bachelor's Degree or equivalent work experience.
  • Minimum two years general business experience.
  • Experience in health care insurance or health care industry preferred, but those with relevant experience in other industries will be considered.
  • Knowledge of Commercial, Medicaid, Medicare and Individual products preferred.
  • Competence in MS Office required, including MSExcel, MSAccess, MSWord.
  • Excellent planning communication, documentation, analytical and problem solving abilities.
  • Ability to work in a fast-paced environment.
  • Must possess strong interpersonal, organizational, and project management skills, with the ability to work on multiple tasks simultaneously.

    Licensure, Certifications, and Clearances:

    UPMC is an equal opportunity employer. Minority/Females/Veterans/Individuals with Disabilities

Salary Range: $21.22 to $36.63 / hour

Union Position: No

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