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   Current UPMC employees must apply in HR Direct

Operations Analyst, Associate

Description

UPMC Health Plan's Medicare HCC Department has an exciting opportunity for a full-time Operations Analyst, Associate!

In this position, the  person will be learning to work with a couple of different applications unique to the Risk Adjustment department. There is an opportunity to broaden experiences and professional growth.


Oversees administrative, system processes, and special projects as they relate to the identification, implementation, and maintenance of the claims transactional system for all UPMC Health Plan products. Under the general direction of Business Support Management, this role will analyze, identify, propose and implement solutions for all business areas. Acts as subject matter expert supporting all areas, and interacts with staff to answer questions and resolve issues as they arise.

This position would be eligible for a mixture of in-office and work-from-home work. Apply today!

Responsibilities:

 

  • Identify areas of concern that may compromise client satisfaction through data analysis, and propose solutions based on findings, expertise, and research
  • Model business requirements for new systems, special projects and enhancements to existing systems; validate and test fixes/enhancements to new and existing systems
  • Openly participate in team meetings, provide ideas and suggestions to ensure client satisfaction, and promote teamwork
  • Completes Executive Summary management documentation as required
  • Performs in accordance with system-wide competencies/behaviors
  • Participates in training programs when available/as requested
  • Effectively prioritize and complete all assigned tasks
  • Identify, administer, test, audit, and implement new processes on transactional claims systems
  • Interface with customers by telephone, correspondence, and or in person to answer inquiries and resolve concerns/issues
  • Performs other duties as assigned
  • Assists other departments during periods of backlogs
  • Manages, updates, and maintains source data dictionaries as they relate to processes
  • Completes inquiries generated from the data reporting and analysis area
  • Maintains employee/insured confidentiality

 

Qualifications

  • Bachelor's Degree or equivalent work experience.
  • Minimum two years general business experience.
  • Experience in health care insurance or health care industry preferred, but those with relevant experience in other industries will be considered
  • Knowledge of Commercial, Medicaid, Medicare and Individual products preferred.
  • Competence in MS Office required, including MSExcel, MSAccess, MSWord.
  • Excellent planning communication, documentation, analytical and problem-solving abilities.
  • Ability to work in a fast-paced environment. Must possess strong interpersonal, organizational, and project management skills, with the ability to work on multiple tasks simultaneously.
  • Experience in QA/Audit/Systems testing development and execution preferred.


Licensure, Certifications, and Clearances:

  • Act 34

  • 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