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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.

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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

Business Process Consultant, Health Plan OPD

  • Job ID: 273198167
  • Status: Full-Time
  • Regular/Temporary: Regular
  • Hours:
  • Shift: Day Job
  • Facility: UPMC Health Plan
  • Department: Business Perform Improve
  • Location: 600 Grant St, Pittsburgh PA 15219
  • Union Position: No
  • Salary Range: $37.20 to $62.96 / hour

Description

Job Summary

Lead or participate in various business performance and process improvement projects/initiatives within the Insurance Services Division. These services will be provided in compliance with state and federal regulations, NCQA standards, and the mission, policies and procedures of the Health Plan and Insurance Services Division. 

 

Responsibilities

Project Delivery and Consulting:

  • Lead or participate in teams to design and implement business process improvements, including:
    • Develop detailed flows of current state processes
    • Participate in the definition of future state options and recommendations using appropriate tools and techniques including benchmarking, data analysis, organization analysis, and process redesign
    • Ensure relevant policies and procedures are revised as required
    • Contribute to the development of business cases to support future state recommendations

Strategic Thinking: 

  • Under the guidance of a more senior BPC, ensure that projects and solutions align with organizational strategies and priorities

Communication and Change Management: 

  • Participate in the development of cross-functional change management and communication strategies to inform and align stakeholders; act as a change agent to support the execution of change management and communication plans

Project Administration:

  • Manage the administrative details of assigned projects, including developing and publishing meeting agendas, collating meeting materials, documenting meeting discussions and decisions, and establishing / maintaining a repository of project documentation

Project Management:

  • Manage assigned projects, including:
    • Define the scope and business requirements of improvement efforts
    • Develop and execute work plans, timelines, and other relevant project management tools
    • Identify and track project issues, resolving them where possible and escalating when necessary
    • Monitor work progress: prepare and present project status reports to appropriate stakeholders
    • Develop and directly oversee the timely creation of reports, presentations, and related materials
    • Design and lead / facilitate productive project meetings

Demonstration of values:

  • Perform in accordance with system-wide competencies, behaviors, and values
  • Maintain accountability for ongoing self-development and knowledge acquisition activities

Leadership:

  • Actively share knowledge with team members and employees across the organization

Methodology:

  • Use standard project documentation, methodologies, and project tracking and reporting formats and tools
  • Participate in the development of new tools, techniques, and resources

Analysis:

  • Analyze relevant data to define and quantify improvement opportunities and quantify the impacts of potential changes on existing processes and organization structure / capabilities
  • Provide analytical support for the establishment of performance and process metrics, including baseline measures and targets; support the development of scorecards and dashboards

 

Qualifications

  • Bachelor's Degree with major in engineering, business, mathematics, statistics, health care, management, or related field. Master's degree in these same areas or related field preferred.
  • 5 years of experience in operations or operations improvement or operations improvement consulting (may include up to 2 years in operational financial analysis).
  • 2 years of experience in data-based process improvement (eg. Six Sigma process improvement) and/or project management of related efforts.
  • PMI's PMP Certification or successful completion of UPMC?s Ulearn Project Management Training series required within one year of hire.
  • Green Belt certification in UPMC's Lean Six Sigma Training program or a comparable program meeting ASQ's Green Belt certification standards required.
  • Strong management, problem solving, organizational, and communication skills (oral and written) are required.
  • Excellent Project Management skills and ability to plan and direct multiple, moderately complex process reengineering projects.
  • Excellent computer skills required, including Excel, Word, PowerPoint, Visio and other pertinent software applications.
  • Experience in health care insurance or the health care industry preferred.
  • Strong leadership and interpersonal skills are required.


Licensure, Certifications, and Clearances:
PMI's PMP Certification required or completion of UPMC Health Plan PM Certification within one year from date of hire.In addition, UPMC Health Plan Lean Six Sigma Green Belt Certification required or a comparable program meeting the ASQ Green Belt certification standards at the time of hire.


UPMC is an Equal Opportunity Employer/Disability/Veteran

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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