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   Current UPMC employees must apply in HR Direct

Administrator, Claims

  • Job ID: 784992167
  • Status: Full-Time
  • Regular/Temporary: Regular
  • Hours:
  • Shift: Day Job
  • Facility: UPMC Health Plan
  • Department: TPA CCBH Claims_Ops
  • Location: 600 Grant St, Pittsburgh PA 15219
  • Union Position: No
  • Salary Range: $32.87 to $56.12 / hour

Description

What We Do:

Claims and Provider Services Cultural Transformation team plays a critical role in nurturing cultural competence and a positive employee work experience in our work community. This is accomplished by partnering with our leaders in alignment with UPMC Values, as well as the Claims and Provider Services Mission, Vision, and Tenants.

 

 Team Vision: 

We are obsessed with work culture and the employee work experience from an operations perspective.  We provide impactful programs, strategies, and best-practice models to create the most desirable work place for the most positive employee work experience influencing them to contribute and thrive as their authentic selves to maximize their value to the organization and work satisfaction. 

 

Responsibilities:

  • Partner and collaborate in the creation of tools, programs, data analysis, and best practice models to support our leaders. The goal is to foster standardization of best practices/information across the entire organization, while recognizing the unique needs of our various teams.
  • Keep pulse on cultural education, activities, initiatives, workgroups, etc. across UPMC and leverage information where appropriate.
  • Keep abreast of cultural issues and trends across industries, broadening our scope of knowledge for cultural innovation, and to drive relevant culture change.
  • Partner and build strategic relationships with leaders, employees, Human Resources, The Center for Employee Engagement, and more to collaborate, learn, and transform culture.
  • Focus on asking the right questions and working with experts to create effective surveys and polls.
  • Hone listening skills to really hear what our employees want, as well as the support leadership needs and ensure we deliver on the ask, ensuring communication along the way.
  • Provide our leaders and employees with information, education, and training opportunities to improve cultural competence and the work experience.
  • Facilitate meetings, presentations, initiatives, collaboration, communication, and teamwork across our teams for the betterment of our workplace.
  •  Communicate and celebrate progress and accomplishments.
  • Seek continuous feedback for improvement in our programs, communication, tools, and best practice models.
  • Operate with a sense of urgency and efficiency, establishing deliverables and timeframes.

 

Qualifications

  • Bachelor's degree in management, organizational leadership, health care, or other related field or equivalent work experience;
  • Self-directed with a minimum of seven years health insurance experience, with at least one year supervising an operation team; along with two years facilitating/coordinating the completion of tasks or projects via others;
  • 3 years customer/client service experience strongly preferred;
  • Prior management experience with automated claims processing is mandatory. Knowledge of medical terminology, ICD-9, and CPT coding required.
  • Knowledge of Commercial, Medicaid, and Medicare products.
  • Experience in training, developing, and coaching staff;
  • Excellent organizational, interpersonal, and written communication skills a must;
  • Strong leadership skills and abilities; strong independent decision-making ability a must.
  • Thorough knowledge of Commercial, Medicare and Medical Assistance programs required.
  • Must be able to simultaneously manage more than four varying operation production inventories; while assisting in resolution of high profile account and client issues;
  • Must be able to thrive in a fast-paced production environment;
  • Project and process management skills strongly preferred;
  • Competence in MS Office and PC skills required.


Licensure, Certifications, and Clearances:

UPMC is an Equal Opportunity Employer/Disability/Veteran

Total Rewards

More than just competitive pay and benefits, UPMC’s Total Rewards package cares for you in all areas of life — because we believe that you’re at your best when receiving the support you need: professional, personal, financial, and more.

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