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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

Senior Data Analyst, Medical Policy

  • Job ID: 220001LG
  • 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 Senior 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 Manager 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:

  • Identify current/future data challenges, develop meaningful recommendations, and provide timely updates on issues encountered.
  • Perform financial analyses in a team-oriented atmosphere and review the analytical outcomes to both clinical and non-clinical audiences.
  • 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.
  • Identify trends in utilization and other areas.
  • Maintain a high level of accuracy and timeliness.
  • Maintains member confidentiality and ensures data accuracy.
  • Master new computer software programs and upgrades, as applicable.
  • Support internal and external projects related to Medical Policy as determined by the Manager, Medical Policy.
  • When necessary, assist company personnel in understanding, implementing and monitoring relevant data and operational requirements.
  • Develop and maintain working relationships with internal UPMC departments, and external contacts as appropriate.
  • Exhibit advanced problem solving using various information sources.
  • Meet deadlines and turnaround times set by department,

Qualifications

  • Bachelor's degree in business, mathematics, engineering, health care or a related field, OR Master's degree in business, mathematics, engineering, health care or a related field (preferred).
  • 3 years of work experience in data analytics.
  • SQL proficiency. MS SQL Server, Toad for Oracle, and Power BI proficiency.
  • 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.

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