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 complies with all governmental requirements related to local, state, and federal COVID-19 vaccination for employment. The Jan. 13 Supreme Court of the United States decision that the Centers for Medicare & Medicaid Services federal COVID-19 vaccine mandate will move forward requires UPMC to ensure employees either get vaccinated or receive a requested medical or religious exemption.

If you are not yet vaccinated, we urge you to get a vaccine now. You can schedule your COVID-19 vaccination through UPMC or visit a non-UPMC provider or UPMC Urgent Care location.

Proof of vaccination is not required upon hire; however, employees will be responsible for ensuring post-hire compliance by getting vaccinated or requesting a medical or religious exemption.

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

Remote Temporary Project Analyst - Medical Policy

Description

UPMC Health Plan's Medical Policy team is seeking temporary support for an assignment that may last up to 6 months.  The selected candidate will have the opportunity to work remotely.  Medical coding experience is preferred but not required.

Responsibilities:

  • Oversee all phases of Medical Policy Department internal projects.
  • Develop and maintain detailed project plans, this includes utilizing standard project documentation and methodology, project tracking, and reporting procedures.
  • Develop and implement key metrics to measure and report on progress of initiatives.
  • Recommend and implement process improvement initiatives within the Medical Policy Department, as well as implementing process improvement initiatives based on management decision.
  • Develop cross-functional, change management and implementation strategies, ensuring that all the participating parties have committed to effective implementation of the processes and procedures.
  • Provide concise and timely status reporting as required.
  • Assist team members in resolving project problems, escalate issues when necessary, and facilitate decision-making.
  • Process Medical Policy report requests.
  • Request regulatory information, fee schedule rates, and prior authorization information materials to initiate policy review. Track and e-file necessary information for use by the Medical Policy Staff. Follow-up as needed.
  • Create and maintain high functioning Medical Policy Documents.
  • Track each Medical Policy (Pay (MP) and Prior Authorization Policy (MP.PA.)) through each step of the annual review process. Ensure regulatory deadlines are met and the workload is balanced appropriately across team members. Maintain and adjust policy schedule as needed.
  • Post the monthly and scheduled policy meetings, upload approved policy edits to applicable systems for policy sponsor approval. Prior to final signatures, review, finalize, and format policy as appropriate (accept changes, remove line numbers, comments, watermarks, etc.)
  • Coordinate all phases of Medical Necessity Form (MNF) management and lead team meetings.
  • Assist Senior Management in running Medical Policy Meetings and presentation of associated meeting materials.
  • Coordinate and oversee Medical Policy - Medical Assistance (DHS-MA) Prior Authorization Review Panel (PARP) Submissions.
  • Coordinate all Medical Policy updates to UM Medical Director (MD) SharePoint site owners. Ensure all Medical Policy documents are updated and accurate according to submission.
  • Monitor HP Medical & Pay policy team mailbox, route questions to appropriate subject matter expert or stakeholder, audit responses, and/or respond to matters timely.
  • Oversee and monitor Medical Policy SharePoint site and appropriate accesses.
  • With the assistance of multiple UPMC Department areas, coordinate Medical Policy external and public postings.
  • Perform monthly policy audits. Identify issues, communicate findings to appropriate stakeholders, and track required updates to the point of completion.
  • Review end of year coding (ICD-10, CPT, and HCPCs) and assist in Medical Policy updates (quarterly and annually).

Qualifications

  • Must be very organized and deadline-conscious.
  • Strong management, problem-solving, organizational, and communication skills (oral and written).
  • Excellent knowledge of spreadsheet and database software.
  • Excellent computer skills required, including Access, Excel, Microsoft Project, and other pertinent computer software packages.
  • Project Management knowledge and ability to manage multiple, complex, and large-scale projects.
  • This position requires effective planning and organizational skills.

Additional Qualities desired:

  • Familiar with Medical Terminology
  • Experience in health care insurance or health care industry preferred.
  • Certified Professional Coder or familiarity of ICD-10, HCPCs, and CPT codes (recommended, not required).

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