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   Current UPMC employees must apply in HR Direct

Manager Clinical Affairs Economics

  • Job ID: 501139762
  • Status: Full-Time
  • Regular/Temporary: Regular
  • Hours:
  • Shift: Day Job
  • Facility: UPMC Health Plan
  • Department: INS Payer Provider
  • Location: 600 Grant St, Pittsburgh PA 15219
  • Union Position: No
  • Salary Range: $38.63 to $65.44 / hour

Description

The Manager of Clinical Affairs Economics provides leadership and direction to the Strategic Analysis of Clinical Affairs operational area to support provider facing incentive programs, Health Plan Reporting, Quality efforts and operational efficiencies. In this position you will maintain oversight and/or direct accountability for provider reporting, and planning and coordination of efforts with other departments to assure effective operations of the Strategic Analysis of Clinical Affairs Department.

Responsibilities:

  • Provide leadership and direction through developing and updating procedures and programs; determine appropriate standards and procedures, staffing requirements and training opportunities.
  • Ensure strong financial and operational performance within the Strategic Analysis of Clinical Affairs (SACA) department through critical decision making to support regulatory compliance and other organizational objectives, as well as developing and implementing Quality Control measures to maintain superior standard of reporting and data quality.
  • Document and maintain policies and procedures of the team / department.
  • Meet deadlines and turnaround times set by department leadership.
  • Lead the planning, design, implementation, organization and administration of the Provider Incentive Programs. Oversee incentive program data analysis, provider facing and internal facing report creation and distribution as well as program payments and related support to provider facing staff. Provide Executive level reporting to support analysis of the program and facilitate continued improvement.
  • Manage and develop assigned staff; hire talented staff and provide training and development tools for staff professional growth. Prepare and distribute work assignments while managing a diverse staff of Economic Analysts.
  • Interact extensively with internal customers to build and maintain positive relationships supporting business goals and objectives; acts as a departmental liaison.
  • Reports directly to Director of Strategic Initiatives, advising and implementing strategic activities to support department objectives; inform and advise on current trends, issues, problems and activities in functional areas and develop/implement appropriate interventions to facilitate problem resolutions and policy making.
  • Develop and maintain data infrastructure, streamlined reporting, standard analyses, and ad hoc reports to support strategic decisions and operational strategy related to various the Health Plan efforts; support Network, Quality, Medical Management, Medical Assistance and other internal departments.
  • Provide timely and accurate reports for staff and management.

Qualifications

  • Bachelor's degree in Healthcare Administration, Hospital Administration, Business, Finance, Accounting, Public Health or a closely related field required.
  • A secondary degree or certification related to Information Systems, Computer Science or Data Analytics is favorable. Equivalent work experience may be considered.
  • Minimum of five years management experience is required.
  • Excellent leadership skills are essential. Must also be collaborative and a team player.
  • Experience in achieving results without direct control over resources; strong influencing skills and demonstrated ability to develop strong interdepartmental relationships.
  • Excellent communication skills; verbal, written and interpersonal.
  • Strong planning, communications, documentation, organizational, analytical, problem solving abilities and change management skills are required.
  • Ability to respond to various needs of internal and external customers in a timely and efficient manner, and direct staff with minimal amount of supervision.
  • Ability to re-engineer processes to positively impact the performance of the department and the overall organization.
  • Excellent analytical and problem solving skills required.
  • Independent decision making ability.
  • Excellent presentation skills, ability to effectively lead meetings.
  • Ability to interact and consult with senior level leadership to achieve department and business unit goals.
  • Superior computer skills and/or demonstrated ability to lead a team with daily IT system demands. Must demonstrate knowledge to leverage system capabilities for continued process improvements.

Licensure, Certifications, and Clearances:

UPMC is an Equal Opportunity Employer/Disability/Veteran

Total Rewards

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Our Values

At UPMC, we’re driven by shared values that guide our work and keep us accountable to one another. Our Values of Quality & Safety, Dignity & Respect, Caring & Listening, Responsibility & Integrity, Excellence & Innovation play a vital role in creating a cohesive, positive experience for our employees, patients, health plan members, and community. Ready to join us? Apply today.

   Current UPMC employees must apply in HR Direct

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