• University of Pittsburgh Medical Center
  • $89,120.00 -138,780.00/year*
  • Philadelphia , PA
  • Financial Services - Banking/Investment/Finance
  • Full-Time
  • 1103 Market St

Description

Community HealthChoices (CHC) is Pennsylvania's managed care long term services and supports (LTSS) program serving seniors and individuals with physical disabilities in the Commonwealth who are covered by Medicare and Medicaid.

Work with users and developers to identify problems and propose solutions. Maintain project planning documents, prepare materials, write and distribute workflow, maintain UPMC systems portfolio (checklist).

Responsibilities:

* Maintain project planning, model business requirements for new systems and enhancements to existing systems.

* Develop administration policies and procedures or business recommendations to ensure uniform, cost effective claims administration practices that comply with the law, plan documents and other company policies.

* Ability to analyze benefit administration issues to determine the need for and the scope of polices and procedures.

* Work with users and developers to identify problems and propose solutions.

* Maintain employee/insured confidentiality.

* Assist other departments during periods of backlogs.

* Effectively prioritize and complete all assigned tasks.

* Openly participate in team meetings, provide ideas and suggestions to ensure client satisfaction, and promote teamwork.

* Identify areas of concern that may compromise client satisfaction.

* Participate in training programs as available/requested.

Qualifications

Bachelor's degree or equivalent related work experience required.Minimum of two years of general business experience required.Minimum of two years of experience in business/industry specialty required. Knowledge of commercial, Medicaid, and Medicare products preferred.Competent in MS Office and PC skills preferred.Working knowledge of COB (Coordination of Benefits) preferred. Organizational, interpersonal, and communication skills required.

Licensure, Certifications, and Clearances:

UPMC is an equal opportunity employer. Minority/Females/Veterans/Individuals with Disabilities
Associated topics: analysis, analyst, bi, business intelligence, examiner, financial analyst, financial analytic, inspect, refine, regulation

* The salary listed in the header is an estimate based on salary data for similar jobs in the same area. Salary or compensation data found in the job description is accurate.

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