Utilization Management Analyst

Job Summary

A company is looking for a Utilization Management Program Analyst.

Key Responsibilities

• Support the development, implementation, and evaluation of the Utilization Management program
• Analyze utilization trends and monitor approval and denial rates
• Coordinate responses to regulatory requests and maintain compliance documentation

Required Qualifications

• Bachelor's degree in healthcare administration, public health, health policy, business, or a related field
• 2-5 years of experience in utilization management, healthcare operations, medical policy, or healthcare analytics
• Minimum of two years of experience in a related role within a healthcare or medical management setting
• Familiarity with medical coding systems (CPT, HCPCS, ICD-10)
• Experience supporting prior authorization programs or utilization management processes