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.

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   Current UPMC employees must apply in HR Direct

Manager, Claims (remote/hybrid)

Description

Are you a leader who desires to make a real difference? Are you ready to lead a consistently high-performing team to greater outcomes? Then this may be the role for you! Our TPA Claim Operations team is seeking a leader who is passionate about creating a positive employee work experience, cultivating the best work culture, and committed to exemplifying our Mission, Vision, and Values. The successful candidate must be willing to advance along our leadership career path for a rewarding and satisfying career.

This position will be 90% remote. Travel to the office will be for needed for occasional meetings, training, etc. (privilege eligibility is subject to continued achievement of business goals and on-site department needs).

The Team

We are a top Healthcare Claim Operations team delivering performance excellence. We take pride in the timely and accurate end-to-end claim adjudication and adjustments for services rendered in a fast-paced, supportive, and innovative work environment.


Responsibilities:

  • Provide leadership and direction through developing and updating procedures, programs, determining appropriate production standards, determining staffing requirements, and training opportunities.
  • Maintenance of communication with established clients.
  • Serve as liaison to clients by participating in demonstrations of operations activities to prospective clients.
  • Effectively interact with internal and external customers.
  • Recruit and discharge employees when necessary.
  • Maintain designated standards established for handling incoming work.
  • Manage and direct all activities and special projects.
  • Provide central coordination and control for implementation of new/changed application and systems.

 

Qualifications

  • Bachelor's Degree preferred.
  • 5 years of business experience required.
  • Prior management experience with automated claims processing is mandatory.
  • Knowledge of medical terminology, ICD-9, and CPT coding required.
  • Knowledge of commercial, Medicaid, and Medicare products.
  • Competent in MS Office and PC skills.
  • Able to demonstrate organizational, interpersonal, and communication skills.
  • Maintain designated production and quality standards.
  • Ability to react to users needs in a timely and efficient manner.
  • Direct staff with minimal amount of supervision.


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