UPMC Health Plan has an exciting opportunity for a Supervisor, Claims position in the CHC Claims Operations department. This is a full-time hybrid position based in the Pittsburgh area. While you’ll primarily work remotely, you’ll come into the office occasionally depending on departmental needs.
Requires management level experience in planning, directing, and responsible for training personnel, prepare and give evaluations to employees and maintain excellent working relationships with all departments. Responsible for team performance, including accurate and timely completion of assigned claim inventories. Ensures effective employee development and training. The Supervisor must use their knowledge and understanding of claim inventory trends and other information generated to identify opportunities to improve claim performance.
Responsibilities:
- Manage special projects
- Work in conjunction with other Supervisors to allocate and adjust team resources as daily needs required
- Identify trends and partner with Support team and Management to make recommendation and improve operational performance
- Participate in interviewing, hiring, and training of team members
- Enhance communication via effective team meetings, huddles, and employee one on ones
- Ensure team performance meets or exceeds claim timeliness and quality standards for regulatory compliance and performance guarantees
- Meet deadlines and turnaround times set by management (these deadlines and turnaround times will, at times, require the employee to work until the project is completed, meaning extended daily work hours, extended work weeks, or both)
- Maintain a positive work environment through employee recognition and interaction
- Strategize, plan, organize, and execute efficient inventory management
- Supervise and monitor ongoing performance of team members.
- Continually examine team performance against department standards.
- This includes timely employee feedback via employee scorecards
- Bachelor's degree in business, health care or management related field or equivalent experience
- Minimum 3 years of health insurance experience preferred
- Minimum 3 years leadership experience (leading, mentoring, coaching, or teaching)
- Excellent planning, communication, documentation, organization, analytical and problem-solving abilities
- Medical Terminology or medical billing experience
- High level of professionalism, enthusiasm, and initiative on a daily basis
- Working knowledge of Commercial, Medicaid and Medicare plans
- Working knowledge regarding Coordination of Benefits
- Ability to maintain quality and production designated standards established for handling work, problem solve effectively and organize workflow
- Ability to handle multiple priorities in a fast-paced production environment
- Some travel may be required.
- Must be able to serve as a positive extension of the management team.
Licensure, Certifications, and Clearances:
UPMC is an Equal Opportunity Employer/Disability/Veteran