Job Description

Job Title: Senior Advisor, Medicare Programs
Job ID: 93481008
Status: Full-Time
Regular/Temporary: Regular
Hours:
Shift: Day Job
Facility: UPMC Health Plan
Department: Medicare & SNP Product
Location: 600 Grant St, Pittsburgh PA 15219

Description

Purpose:

The Senior Advisor, Medicare Advantage Program brings together a diverse set of senior skills and experience, including advanced analytics methods, broad-based business and Medicare policy knowledge, and insights derived from consulting experience in healthcare. The Senior Advisor, Medicare Advantage Program reports to the AVP, Medicare Product and Analytics and serves to continuously enhance the decision support needs of senior leadership into actionable and impactful efforts. The Senior Advisor, Medicare Advantage Program must demonstrate credibility and thought leadership on multiple, diverse fronts, including but not limited to clinical, financial, operations, policy, and product; engage with stakeholders to identify new opportunities regarding current business issues; lead development of business case-style assessments of initiatives proposed by clinical or other business units to support business decisions; and inform development of strategic business modeling based on insights. The Senior Advisor, Medicare Advantage Program will leverage his/her diverse, senior-level experience to drive an enhanced business proposition for services developed and delivered to internal and external customers.


Responsibilities:

  • As a member of the Medicare Advantage leadership team, support AVP of Medicare Advantage Product and Analytics by bringing innovative strategic and tactical ideas and advising on methodological approaches for strategic and tactical business decisions and solutions. Apply first-hand knowledge of best practices, gleaned from national-level consulting leadership and technology domain experience, to further Medicare Advantage efforts.
  • Collaborate with multi-disciplinary leaders and senior executives including but not limited to from clinical, financial, pharmacy, legal, and government affairs to help further Medicare Advantage efforts to help improve the lives of members.
  • Research and analyze existing and new Medicare-relevant regulations and policies and advise direction of analysis and product development. Identify, track, and report on legislation (upcoming and current) and trends (regional and national) that have implications on Medicare Advantage.
  • Evaluate Medicare Advantage related announcements and its impact on product design.
  • Working with Product and Analytics teams, respond to requests from senior executives, especially Vice President of Medicare and Chief Medicare Officer, on Medicare-related issues that require analyses and modeling that enable C-level decision making at the strategic and tactical levels.
  • Produce best-in-practice white papers and briefs that inform Medicare Advantage product development.
  • Produce concise and informative presentations for stakeholders that include senior executives, and for both technical and nontechnical audiences.
  • Support business efforts within Medicare Advantage department and working with Directors of Product and Analytics to enhance strategic business modeling methods for product design. 


Qualifications

  • Advanced degree in a quantitative discipline that emphasizes applied analysis of complex systems such as Statistics, Decision Science, Economics, Operations Research/Operations Engineering, Applied Mathematics, Health Services Research or related field.
  • PhD highly preferred. 
  • Equivalent work experience specifically related to practical application of advanced analytics modeling to complex business systems will be considered.
  • Ten or more years of experience in quantitative methods or other relevant work are required.
  • Ten or more years of healthcare insurance industry and/or healthcare delivery industry experience are highly preferred.
  • Demonstrated advanced business acumen in a senior leadership role that integrates analytics, operations, and financial principles, is required.
  • Extensive experience with formulation and practical application of business models to accurately simulate complex business systems is required.
  • Excellent written and oral communication skills, with the ability to communicate complex strategic and technical findings to Sr. Management decision makers, including the C-suite, are required.
  • Ability to influence senior decision makers is a must.
  • Demonstrated leadership experience in a healthcare industry consulting role, engaging clients at the national level, is highly desired.
  • Person must demonstrate a high degree of professionalism, enthusiasm, and initiative daily.
  • Ability to work in a fast-paced, complex environment is a must.
  • Attention to detail is critical to the success of this position, as is the ability to establish collaborative working relationships across business units that include colleagues with diverse clinical and business skill sets and analytics acumen.


Licensure, Certifications, and Clearances:

UPMC is an Equal Opportunity Employer/Disability/Veteran

Salary Range: $0 / hour

Union Position: No

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