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

Administrator, Medicare Compliance

  • Job ID: 384111011
  • Status: Full-Time
  • Regular/Temporary: Regular
  • Hours:
  • Shift: Day Job
  • Facility: UPMC Health Plan
  • Department: Medicare Compliance
  • Location: 600 Grant St, Pittsburgh PA 15219
  • Union Position: No
  • Salary Range: $31.08 to $52.46 / hour

Description

UPMC Health Plan is seeking an Administrator of Medicare Compliance!

Position incumbent will report directly to the Manager, Medicare Compliance. The Administrator will assist the Manager in coordinating the Health Plan's efforts to ensure compliance with laws, regulations, and policies affecting the Medicare line of business.

This is a hybrid position (Combination of in-office and work-from-home). 

Responsibilities:

  • Perform special projects as assigned by the Manager, Medicare Compliance.
  • Maintain highly organized and very detailed on-line and hard copy filing systems to facilitate effective, accurate responses to internal and external requests.
  • Coordinate participation of various health plan subject matter experts in periodiccommittee and subcommittee meetings as well as local and/or regional conferences andworkshops impacting the health plan's ability to comply with the Medicare Programrequirements.
  • Responsible for the accurate communication of Medicare contractual requirements and guidance throughout the health plan, as well as the internal coordination of compliance activities.
  • Responsible for the accurate communication of Medicare contractual requirements and guidance throughout the health plan, as well as the internal coordination of compliance activities.
  • Participate in Policy and Procedure Subcommittee meetings.
  • Partner with health plan staff in preparing accurate on-site visit reports and sending approved responses to CMS while working with supervisor to ensure any corrective action plans are sufficiently addressed by appropriate health plan departments.
  • Responsible for CMS Audit preparation of materials, including binder preparation and mock audits.
  • Serve as a liaison to the Centers for Medicare and Medicaid Services (CMS) ensuring in the resolution of enrollment, payment or regulatory issues.
  • Coordinate with supervisor in preparation of status reports to senior management and periodic updates relative resulting from on-site visits and/or audits.
  • Assist supervisor with management of third-party vendors hired to enhance program oversight.
  • Work with the supervisor to coordinate the various elements of state regulatory filings, as needed..
  • Assist in the development of Medicare policies and procedures.
  • Conduct research on Medicare regulations.

 

Qualifications

  • Bachelor's Degree required.
  • Two to five years of demonstrated experience/knowledge of regulatory compliance or program management preferred.
  • Medicare Advantage experience, Microsoft Office experience
  • Clinical experience preferred
  • Excellent organizational capabilities with ability to work effectively as a team player.
  • Ability to continuously interact effectively and professionally with all levels of staff.
  • Excellent written and oral communication skills.
  • Ability to handle multiple priorities/projects in a fast-paced professional environment.
  • Working knowledge of word-processing and database software.
  • Demonstrated performance in meeting time-sensitive deadlines with minimal supervision


Licensure, Certifications, and Clearances:

UPMC is an Equal Opportunity Employer/Disability/Veteran

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   Current UPMC employees must apply in HR Direct

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