Hybrid Operations Analyst, Intermediate - Claims & Analytics

Socket.dev; Pittsburgh (Allegheny County); On-site; USD 65,000 - 90,000; Full time

Job summary

UPMC Health Plan has an exciting opportunity for an Operations Analyst, Intermediate in the Core System Operations department. This full-time hybrid role is based in the Pittsburgh area.

The position analyzes financial, clinical and other data to identify opportunities to improve performance, leads process enhancements, and supports multiple systems and projects. Strong candidates will have healthcare experience, solid MS Office and SQL skills, and excellent communication and project-management

Qualifications

• Bachelor's Degree or equivalent work experience.
• Minimum four years general business experience.
• Experience in health care insurance preferred.
• Knowledge of Commercial, Medicaid, Medicare and Individual products preferred.
• Excellent planning communication, documentation, analytical and problem-solving abilities.
• Ability to work in a fast-paced environment.
• Must possess strong interpersonal, organizational, and project management skills.

Responsibilities

• Interface with customers by telephone, correspondence, and or in person to answer inquiries and resolve concerns/issues
• Openly participate in team meetings, provide ideas and suggestions to ensure client satisfaction, and promote teamwork
• Effectively prioritize and complete all assigned tasks
• Identify areas of concern that may compromise client satisfaction through data analysis, and propose solutions based on findings, expertise, and research
• Maintains departmental Policy and Procedure documentation; completes annual policy review making necessary updates as required
• Participates in training programs when available/as requested
• Assists other departments during periods of backlogs
• Manages special projects as assigned by Management team; develops/maintains project plans, as needed
• Administer, identify, test, audit, and implement new processes on transactional claims systems
• Model business requirements for new systems, special projects and enhancements to existing systems; validate and test fixes/enhancements to new and existing systems
• Allocates the Operations Analysts time appropriately to meet production and quality standards
• Trains new and existing employees on departmental policies and procedures
• Attends meetings on behalf of Management team
• Maintains employee/insured confidentiality
• Performs other duties as assigned
• Manages, updates, and maintains source data dictionaries as they relate to processes
• Completes inquiries generated from the data reporting and analysis area
• Provides support to Operations Analysts
• Performs in accordance with system-wide competencies/behaviors
• Completes Executive Summary management documentation as required

Skills

Analytical thinking

MS Office proficiency

Project management

Communication skills

Interpersonal skills

Education

Bachelor's Degree or equivalent work experience

Tools

SQL

SSIS

Oracle

MS Access

MS Excel

MS Word

Job description

UPMC Health Plan has an exciting opportunity for an Operations Analyst, Intermediate in the Core System Operations department. This full-time hybrid role is based in the Pittsburgh area.

The position analyzes financial, clinical and other data to identify opportunities to improve performance, leads process enhancements, and supports multiple systems and projects. Strong candidates will have healthcare experience, solid MS Office and SQL skills, and excellent communication and project-management