Hybrid Business Analyst I: Member Grievances & Processes

UPMC; Pittsburgh (Allegheny County); Hybrid; USD 65,000 - 90,000; Full time

Job summary

UPMC Health Plan is recruiting a Member C&G Business Analyst I for the Member CGA department. The role is full-time with a hybrid schedule (home-based with occasional office visits).

You will collaborate with users and developers to identify problems, document processes, and implement improvements across C&G and the Insurance Services Division. The Analyst will maintain confidentiality, mentor staff, analyze data for cost savings and member satisfaction, and manage small projects.

Responsibilities

• Maintain employee/insured confidentiality.
• Identify areas of concern that may compromise client satisfaction.
• Participate in team meetings, provide ideas and suggestions to ensure client satisfaction.
• Be a point of contact for coordinators and leadership for reporting questions.
• Mentor new C&G staff by shadowing, training, and providing recommendations on employee growth.
• Monitor quality of C&G Coordinators, identify errors, and provide feedback to leadership.
• Develop training materials for Coordinators and other C&G staff.
• Collaborate with department leadership to ensure processes are current and protocols are being consistently implemented.
• Manage small special projects for C&G and the Insurance Services Division.
• Complete External Grievances and External Complaints daily, including submission to IROs/EROs.
• Participate in department audits, including risk-assessment, timely-submission, and gathering of requested information.
• Analyze C&G data to identify trends and opportunities to reduce costs and increase member satisfaction.
• Prioritize and complete all assigned tasks, consistently attaining timely results.
• Collaborate with users and developers to identify problems and propose solutions.
• Plan and lead assignments with minimal supervisor oversight.
• Maintain project planning and model business requirements for new systems and enhancements.
• Identify opportunities to streamline processes or eliminate unnecessary steps.

Skills

Business analysis

Requirements gathering

Stakeholder communication

Process mapping

Job description

UPMC Health Plan is recruiting a Member C&G Business Analyst I for the Member CGA department. The role is full-time with a hybrid schedule (home-based with occasional office visits).

You will collaborate with users and developers to identify problems, document processes, and implement improvements across C&G and the Insurance Services Division. The Analyst will maintain confidentiality, mentor staff, analyze data for cost savings and member satisfaction, and manage small projects.