Utilization Management Analyst

Job Summary

A company is looking for an Analyst, Utilization Management.

Key Responsibilities

• Serve as a subject matter expert for configuration in the prior authorization system and related reporting
• Maintain and audit prior authorization criteria and notification workflows to ensure compliance and accuracy
• Implement new client prior authorization benefit designs and support capacity planning for systems

Required Qualifications

• College degree in a science or business-related field, CPhT, or at least 2 years of relevant experience
• Experience with prior authorization processes or within a pharmacy benefit manager (PBM) is preferred
• Intermediate to expert knowledge of the Microsoft Office Suite
• Hands-on troubleshooting experience with complex multi-user business applications
• Knowledge of Medicare D regulatory requirements is required prior to or soon after hire