Job Summary

A health insurance company is seeking a Remote Compliance Utilization Management Professional.

Core Responsibilities Include:

• Reviewing and interpreting new CMS and regulatory requirements
• Managing tasks and timelines to ensure compliance with regulatory initiatives
• Working with the business area in updating policies and procedures

Required Skills:

• Knowledge of accreditation in AAAHC
• Experience in identifying risk and reviewing reports and data analysis
• Proficiency in Microsoft Office Products Word, Excel, Outlook, Power Point
• 1-2 years of work experience in compliance, auditing, health plan, utilization management, or coverage determinations