UPMC Health Plan has an exciting opportunity for a Provider Monitoring Specialist, Associate position in the Community HealthChoices department. This is a full time position working Monday through Friday 7:30 a.m. to 4:00 p.m. This position will require going into provider offices and traveling in Philadelphia, PA and surrounding counties.
This position supports Home and Community Based Providers (HCBS) in gaining operational efficiencies by identifying and addressing process improvement opportunities. This position also performs on-going monitoring to ensure provider compliance with both internal UPMC and governmental regulatory requirements.
Responsibilities:
- Ability to explain results of findings to internal and external stakeholders.
- Generate accurate and detailed reports for effective monitoring, trending, and analysis.
- Identify areas of concern or provider deficiencies through data analysis and propose solutions based on findings and established protocols.
- Effectively prioritize and complete all assigned tasks.
- Communicate effectively and regularly with other team members, management, and applicable stakeholders.
- Successfully manage assigned projects and initiatives
- Bachelors Degree and/or equivalent education or work experience.
- 2 years general business experience required.
- Drivers Licenses Required.
Licensure, Certifications, and Clearances:
- Automotive Insurance
- Driver's License
- Act 34
UPMC is an Equal Opportunity Employer/Disability/Veteran