Job Summary
A non-profit health insurance company specializing in public healthcare programs is seeking a Remote Public Healthcare Programs Utilization Management Manager.
Must be able to:
- Assist in coordination and management of the pre-determination process of medical and dental services
- Assist in the development of integrated service delivery to members and oversee utilization management data and processes
- Review and revise workflows to maximize efficiencies
Skills and Requirements Include:
- Minimum of 5 years of clinical experience is required
- Minimum of 5 years of experience in one of the following: case management, utilization management, and/or quality improvement
- Beginning Excel, Word and PowerPoint experience
- Experience in data analysis and trending
- Knowledge of utilization management standards and practices
- Communication skills
