Job Description

Job Title: Business Analyst, Senior- Medicaid Programs
Job ID: 22572178
Status: Full-Time
Regular/Temporary: Regular
Hours:
Shift: Day Job
Facility: UPMC Health Plan
Department: 68740 HPLAN Medicaid Programs
Location: 600 Grant St, Pittsburgh PA 15219

Description

UPMC Health Plan is hiring a full-time Business Analyst, Senior to help support the Medicaid Department for its downtown Pittsburgh location at the US Steel Tower. This is a Monday through Friday daylight position. The Business Analyst, Senior will support and coordinate inquiries and responses related to the Medical Assistance Department’s operational related activities to meet or exceed the expectations of the Pennsylvania Department of Human Services (DHS).

Responsibilities:

  • Project coordinate operational related activities and inquiries supporting the UPMC Health Plan’s Medical Assistance Program. Ensure that correspondence is monitored and accurately communicated appropriately to stakeholders throughout Health Plan, and that all pertinent operational activities, responses, and reporting requirements are submitted to DHS in a timely manner as required.
  • Support (and fill-in as a backup capacity to) the staff maintaining the operational correspondence mailbox and tracking database utilized for operational complaint resolution, daily issue tracking, as well as both reoccurring and ad hoc reporting.
  • Build and maintain positive relationships with internal and external stakeholders.
  • Attend meetings as a representative of the Medicaid Correspondence Team.
  • Prepare agenda and arrange other logistics for operational activities/meetings between the Health Plan and DHS.
  • Conduct primary and secondary research as necessary (e.g. on-line, review of hard-copy manuals, verbal communication, etc.) to prepare accurate and timely responses to internal/external and DHS requests for information including (but not limited to) member and provider complaints or other miscellaneous inquiries.
  • Work with various internal departments including (but not limited to) Medical Assistance Administration, Finance, Community Outreach, and Operations to carry out tactical directives resulting from strategic product development meetings related to the Medical Assistance Program.Compile appropriate data (utilizing the departmental database or other sources) for weekly status reports to senior management relative to outstanding issues, ongoing and completed departmental assignments, or interdepartmental projects as needed.
  • Assist in the update of product training materials, and work with the Operational Team to provide the training to new employees as needed.
  • Participate in improvement sessions with various management staff and stakeholders within the Medical Assistance Department or other internal departments and to continually enhance the quality and timeliness of Health Plan operational activities and responses to DHS.
  • Participate in the development, review/edit and distribution of Health Plan member and provider materials while following established protocol for seeking DHS prior approval.
  • Meet deadlines and turnaround times set by management (these deadlines and turnaround times will, at times, require the employee to work until the project is completed, meaning extended daily work hours, extended work weeks, or both as necessary).
  • Perform special projects as periodically assigned by management.

Qualifications

  • Bachelor's degree in business, mathematics, statistics, health care, management or a related field required.
  • Master's degree preferred. 
  • 5 years experience in financial and/or medical analysis. Or Successful Completion of the FMR Program.
  • Experience in health care industry preferred, but those with relevant experience in other industries will be considered.  
  • Prior experience with government products, especially Medicaid, is highly preferred
  • Superior computer skills in standard Microsoft Office applications such as Word, Excel and PowerPoint, and a working knowledge of the Microsoft Access application required. 
  • Person must demonstrate a high degree of professionalism, enthusiasm and initiative on a daily basis. 
  • Ability to work in a fast-paced environment a must. 
  • Will need to manage multiple tasks and projects, and forge strong interpersonal relationships within the department, with other departments, and with external audiences. 
  • Attention to detail is critical to the success of this position, with demonstrated competency in customer orientation and the ability to deal with ambiguity. 
  • Excellent planning, communication, documentation, organizational, analytical, and problem-solving abilities. 
  • Ability to interpret and summarize results of various analyses in a timely and meaningful way. 
  • Ability to effectively approach problem solving. 
  • Ability to re-engineer processes to positively impact productivity in terms of timeliness and accuracy. 
  • Candidates who are well-informed and conversant with general business and clinical matters are preferred.


Licensure, Certifications, and Clearances:

UPMC is an Equal Opportunity Employer/Disability/Veteran

Salary Range: $27.98 to $47.14 / hour

Union Position: No

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