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UPMC continues to comply with governmental guidance related to local, state, and federal COVID-19 vaccination for employment. All employees and affiliated staff of UPMC entities are considered essential health care workers and will be accountable to follow the Centers for Medicare & Medicaid Services (CMS) federal vaccine mandate. To be compliant with the federal mandate, employees must complete the approved vaccination dosage regimen currently defined by the federal government. Compliance with the federal mandate is encouraged before hire. Medical and religious exemption requests may be submitted for consideration.

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Business Analyst III

  • Job ID: 435989441
  • Status: Full-Time
  • Regular/Temporary: Regular
  • Hours: 8am-5pm
  • Shift: Day Job
  • Facility: UPMC Health Plan
  • Department: CHC Statutory Reporting
  • Location: 600 Grant St, Pittsburgh PA 15219
  • Union Position: No
  • Salary Range: $29.18 to $49.16 / 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 hybrid and will report into the office at US Steel Tower 2-3 days a week.


Manage comprehensive analysis of data and information for various UPMCHP products. Business Analyst III will take a leadership role in the enhancement, development, documentation, and communication of identified variances. To successfully perform the role the Business Analyst III must understand the causes of financial & clinical trends and anomalies. The Business Analyst III must use their knowledge and expert understanding of financial, clinical, and other information generated by numerous sources to identify opportunities to improve clinical and financial performance. Furthermore, the position requires the ability to articulate these opportunities to internal and external audiences, implement the solutions, and track and monitor progress. These functions must be done while also weighing the practical considerations and potential barriers that need to be overcome to successfully implement new programs and processes.

Responsibilities:

  • Ability to extract and define relevant information within patient/member or other business operations data.
  • Monitor patient/member access and utilization data against regional and national benchmarks.
  • Complete complex financial/operational analysis from beginning to end with minimal supervision or direction from supervisor. Ability to strategize new ways of trending/analyzing data in order to complete analysis.
  • Implement and monitor effectiveness of these solutions.
  • Must carry out all responsibilities with minimal direct supervision.
  • Develop access, utilization, and financial/operations reports for forecasting, trending, and result analysis.
  • Perform in-depth statistical and qualitative analyses related to business operations particularly, patient/member access data and utilization. Ability to explain this analysis to a non-technical audience of both internal and external customers, including executive management.
  • Interpret and trend business operations, access, and utilization data. Take initiative to investigate variances and derive conclusions and solutions from this data.
  • Meet deadlines and turnaround times set by department manager and director. These deadlines and turnaround times will, at times, require the employee to work until project is completed, meaning extended daily work hours, extended work weeks, or both.

 

Qualifications

  • B.A. degree in business, mathematics, statistics, health care, management, or a related field. Master's degree preferred. Extensive related experience will be considered.
  • 4 years experience in financial and/or medical analysis or successful completion of the FMR Program.
  • Experience in health care insurance or health care industry is preferred, but those with relevant experience in other industries will be considered.
  • Superior computer skills with expert knowledge in Access, Excel, Crystal Reports, and other financial & statistical software packages.
  • Demonstrate a high degree of professionalism, enthusiasm, and initiative on a daily basis.
  • Ability to work in a fast-paced environment is a must.
  • Ability to manage multiple tasks and projects, and forge strong interpersonal relationships within the department, with other departments, and with external audiences.
  • Attention to detail is critical to the success of this position, with demonstrated competency in customer orientation and the ability to deal with ambiguity.
  • Excellent planning, communication, documentation, organizational, analytical, and problem-solving abilities.
  • Advanced mathematical skills.
  • Ability to interpret and summarize results of various analyses in a timely and meaningful way.
  • Ability to effectively approach problem-solving.
  • Ability to re-engineer processes to positively impact productivity in terms of timeliness and accuracy.
  • Possess technical knowledge and expertise in understanding patient access, physician template utilization, healthcare revenues, reimbursement, and the correlation to the monthly financial statements.
  • Ability to analyze financial & clinical results and to comprehend forecasting models.
  • Knowledge and expert understanding of all products and benefit designs of UPMC Health Plan insurance offerings, across all lines of business.
  • Well-informed and conversant with general business, economic, and clinical matters.
  • Available to work overtime if required.

 

Preferences:

  • Strong preference for intermediate/strong SQL skills
  • Strong preference for advanced Excel skills
  • Strong analytical experience
  • Strong preference for Financial experience

Licensure, Certifications, and Clearances:

  • Act 34

  • UPMC is an Equal Opportunity Employer/Disability/Veteran

 

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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