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   Current UPMC employees must apply in HR Direct

Provider Monitoring Specialist-Associate (Philadelphia)

  • Job ID: 915725534
  • Status: Full-Time
  • Regular/Temporary: Regular
  • Hours: 7:30-4:30pm
  • Shift: Day Job
  • Facility: UPMC Health Plan
  • Department: Community HealthChoices
  • Location: 510 Walnut St, Philadelphia PA 19106
  • Union Position: No
  • Salary Range: $25.81 to $44.67 / hour

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.


This position supports Home and Community Based Providers (HCBS) in gaining operational efficiencies by identifying and addressing process improvement opportunities. This position also performs on-going monitoring to ensure provider compliance with both internal UPMC and governmental regulatory requirements.

Responsibilities:
  • Ability to explain results of findings to internal and external stakeholders.
  • Generate accurate and detailed reports for effective monitoring, trending, and analysis.
  • Identify areas of concern or provider deficiencies through data analysis and propose solutions based on findings and established protocols.
  • Effectively prioritize and complete all assigned tasks.
  • Communicate effectively and regularly with other team members, management, and applicable stakeholders.
  • Successfully manage assigned projects and initiatives

Qualifications

Bachelors Degree and/or equivalent education or work experience. Two years general business experience required.

Licensure, Certifications, and Clearances:
Driver's License

UPMC is an Equal Opportunity Employer/Disability/Veteran

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   Current UPMC employees must apply in HR Direct

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