Operations Analyst, Intermediate - Hybrid

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

Job summary

UPMC Health Plan in Pittsburgh is seeking an Intermediate Operations Analyst to support Core System Operations in a full-time hybrid role. You will handle inquiries, analyze data, and help optimize transactional claims processes.

Key responsibilities include project management support, testing new systems, and maintaining documentation. The ideal candidate has strong MS Office skills, experience in health care, and solid data analysis capabilities.

Qualifications

• Bachelor's degree or equivalent work experience.
• Minimum four years general business experience.
• Experience in health care insurance or health care industry preferred, but those with relevant experience in other industries will be considered.
• Knowledge of Commercial, Medicaid, Medicare and Individual products preferred.
• Competence in MS Office required, including MS Excel, MS Access, MS Word.
• Competence of the most common features of specialized analysis and reporting tools, e.g. SQL, SSIS, Oracle, and MS Office Suite.
• 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, with the ability to work on multiple tasks simultaneously.
• Experience in QA/Audit/Systems testing development and execution preferred.

Responsibilities

• Interface with customers by telephone, correspondence, or in person to answer inquiries and resolve concerns/issues.
• Participate in team meetings, provide ideas to ensure client satisfaction, and promote teamwork.
• Prioritize and complete all assigned tasks.
• Identify areas of concern that may impact client satisfaction through data analysis and propose solutions.
• Maintain departmental Policy and Procedure documentation and update annually.
• Participate in training programs when available.
• Assist other departments during backlogs.
• Manage special projects and develop/maintain project plans.
• Administer, test, audit, and implement new processes on transactional claims systems.
• Model business requirements for new systems and validate fixes/enhancements.
• Allocate time to meet production and quality standards.
• Train new and existing employees on policies and procedures.
• Attend meetings on behalf of Management.
• Maintain confidentiality of employees/insured.
• Perform other duties as assigned.
• Manage, update, and maintain source data dictionaries.
• Complete inquiries from the data reporting and analysis area.
• Provide support to Operations Analysts.
• Adhere to system-wide competencies/behaviors.
• Complete Executive Summary management documentation.

Skills

Interpersonal skills

Organizational skills

Project management

Analytical thinking

Problem-solving

Multitasking

Adaptability

Education

Bachelor's degree or equivalent

Tools

SQL

SSIS

Oracle

MS Excel

MS Access

MS Word

MS Office Suite

Job description

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

Responsibilities:

• Interface with customers by telephone, correspondence, 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 or 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 Analyst's 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

Qualifications:

• Bachelor's Degree or equivalent work experience.
• Minimum four years general business experience.
• Experience in health care insurance or health care industry preferred, but those with relevant experience in other industries will be considered
• Knowledge of Commercial, Medicaid, Medicare and Individual products preferred.
• Competence in MS Office required, including MSExcel, MSAccess, MSWord.
• Competence of the most common features of specialized analysis and reporting tools, e.g. SQL, SSIS, Oracle, and MS Office Suite.
• 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, with the ability to work on multiple tasks simultaneously.
• Experience in QA/Audit/Systems testing development and execution preferred.

Licensure, Certifications, and Clearances:

• ACT 34

UPMC is an Equal Opportunity Employer/Disability/Veteran