COVID-19 Vaccination Information

Across UPMC, our guiding principle is to always prioritize the safety of our employees, patients, and members. UPMC believes that vaccination is important, helps protect all, and advocates that everyone who can be vaccinated should be vaccinated.

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.

For more information about UPMC’s response to COVID-19, please visit UPMC.com/coronavirus.

Search Our Jobs

   Current UPMC employees must apply in HR Direct

Sr. Data Analyst, Medical Policy

  • Job ID: 546933464
  • Status: Full-Time
  • Regular/Temporary: Regular
  • Hours:
  • Shift: Day Job
  • Facility: UPMC Health Plan
  • Department: Medical Director Service
  • Location: 600 Grant St, Pittsburgh PA 15219
  • Union Position: No
  • Salary Range: $26.58 to $46.02 / hour

Description

UPMC Health Plan is hiring a full-time Sr. Data Analyst, Medical Policy to support the Medical Director Service Department for its downtown Pittsburgh location at the US Steel Tower. This is a Monday through Friday daylight position.

Under the supervision of the Senior Medical Director of Medical Policy, the Senior Medical Policy Data Analyst designs, analyzes and presents analytical solutions to support data-based decision making in the department and throughout the organization to improve elements such as organizational performance and member care. Various health plan data systems will be used as the data sources. Final aggregation and presentation will be completed through various software packages, including Toad for Oracle, SQL Server, and Power BI. The Senior Medical Policy Data Analyst must be able to work both independently as well as in a team setting. Under the direction of the Senior Medical Director of Medical Policy, lead process and data analysis automation projects as well as other internal and external projects related to Medical Policy.

Responsibilities:

  • When necessary, assist company personnel in understanding, implementing and monitoring relevant data and operational requirements.
  • Support internal and external projects related to Medical Policy as determined by the Senior Medical Director of Medical Policy.
  • Research, develop, and assist in the implementation of process and data analysis automation strategies for the department.
  • Stay abreast on new solutions relevant to the department through self-study.
  • Perform financial analyses in a team-oriented atmosphere and review the analytical outcomes to both clinical and non-clinical audiences.
  • Meet deadlines and turnaround times set by department (these deadlines and turnaround times will, at times, require the employee to work until the project is completed, meaning extended daily work hours, extended work weeks, or both).
  • Master new computer software programs and upgrades, as applicable.
  • Maintains member confidentiality and ensures data accuracy.
  • Maintain high level of accuracy and timeliness.
  • Identify trends in utilization and other areas.
  • Identify current/future data challenges, develop meaningful recommendations, and provide timely updates on issues encountered.
  • Exhibit advanced problem solving using various information sources.
  • Develop and maintain working relationships with internal UPMC departments, and external contacts as appropriate.

Qualifications

  • Bachelor's degree in business, mathematics, engineering, health care or a related field required
  • Master's degree in business, mathematics, engineering, health care or a related field preferred
  • 3 years of work experience in a Medical Policy department
  • SQL proficiency MS SQL Server, Toad for Oracle, and Power BI proficiency
  • Experience with InterQual Customization software prererred
  • Medical coding (CPT, HCPCS, ICD-10, DRG) experience
  • MS Office proficiency
  • Excellent interpersonal, oral and written communication skills
  • Must work well independently and within a team
  • Experience with other programming languages (e.g., Python, R) 
  • Experience with process and data analysis automation


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