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Provider Monitoring Specialist- Associate (Central)

  • Job ID: 347261271
  • Status: Full-Time
  • Regular/Temporary: Regular
  • Hours: 7:30am-4pm
  • Shift: Day Job
  • Facility: UPMC Health Plan
  • Department: Community HealthChoices
  • Location: Work From Home
  • Union Position: No
  • Salary Range: $27.17 to $42.45 / 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 will be work from home but requires travel into the community. Strong preference for candidates that reside in State College, Carlisle, Harrisburg, or Williamsport. 

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:

 

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

 

Qualifications

Qualifications:

  • Bachelors Degree and/or equivalent education or work experience.
  • 2 years of general business experience required

Preferences:

  • Strong Excel skills 
  • Strong written and oral communication skills
  • Strong preference for candidates that reside in State College, Carlisle, Harrisburg, or Williamsport. 



Licensure, Certifications, and Clearances:

  • Driver's License
  • 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