Job Details

A company is looking for a Specialist, Utilization Management.Key ResponsibilitiesSupport the evolution of the Utilization Management program by identifying improvement opportunitiesMonitor vendor performance against contractual SLAs and collaborate on corrective action plansFacilitate issue resolution with health plan partners, vendors, and provider services teamsRequired QualificationsBachelor's Degree or equivalent combination of education and experience2+ years of relevant experience in utilization management operations or healthcare operationsExperience working with external vendors or health plans in a UM capacity preferredWorking knowledge of utilization management principles and prior authorization processesProficiency in SmartSheets, Microsoft Word/Excel, and PowerPoint