Community Health Choices will impact more than 400,000 people statewide who are dually eligible for Medicare and Medicaid or receive Medicaid funded long-term services and supports (LTSS).
Through Community HealthChoices (CHC), we will coordinate physical health care and LTSS to enhance the quality of life and independence for frail seniors and adults with disabilities in home and community based environments as well as in institutional settings. Our care model, built on our high-quality Medicare Advantage Dual Eligible Special Needs Plan (D-SNP) platform, supported by the resources of our integrated payer-provider UPMC, and through deep community collaboration, will help assure the highest level of services are provided.
The BAII will be responsible for performing analysis of data and information for the new Community HealthChoices team. He/she will take a leadership role in the enhancement, development, documentation, and communication of identified variances.
Identify trends in expenses, utilization, medical quality, and other areas.
Investigate variances and derive solutions to cost increases and quality issues.
Manage special projects.
Meet deadlines and turnaround times set by managers and department director (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).
Monitor business unit operating performance against regional, national and international benchmarks.
Perform cost/benefit analysis.
Perform statistical analyses, and then explain this analysis to a non-technical audience of both internal and external customers and, at times, senior management.
Bachelors degree in mathematics, statistics, health care, management, or related business field required.
Masters degree preferred.
Extensive related experience will be considered.
Minimum of two years of related work experience in financial and/or medical analysis required.
Experience in health care insurance or health care industry preferred.
Strong computer skills, with expert knowledge in Access, Excel, Crystal Reports, Cognos Reports, and other financial & statistical software packages.
Ability to work in a fast-paced environment a must.
Ability to manage multiple tasks and projects, and forge strong interpersonal relationships within the department, with other departments, and with external audiences.
Attention to detail is critical to the success of this position.
Excellent planning, communication, documentation, organizational, analytical, and problem solving abilities.
Advanced mathematical skills.
Ability to interpret and summarize results of various analyses in a timely and meaningful way.
Ability to effectively approach problem solving.
Ability to re-engineer processes to positively impact productivity in terms of timeliness and accuracy.
Ability to analyze financial & clinical results and to comprehend forecasting models.
Knowledge and good understanding of all products and benefit designs of UPMC Health.
Licensure, Certifications, and Clearances:
UPMC is an equal opportunity employer. Minority/Females/Veterans/Individuals with Disabilities