Utilization Management Auditor

Job Summary

A company is looking for a Utilization Management Auditor.

Key Responsibilities

• Audit all stages of the Utilization Management process for compliance and effectiveness
• Evaluate workflows impacting other departments to identify systemic issues and recommend improvements
• Compile audit findings into reports and provide actionable recommendations for process enhancement

Required Qualifications

• High school diploma or GED required; Bachelor's degree in a relevant field preferred
• 3-5 years of experience in healthcare operations, Utilization Management, or auditing roles
• In-depth knowledge of UM processes and familiarity with healthcare regulations
• Certification in Healthcare Compliance or similar certifications is highly desirable
• Experience in developing reporting systems related to audit activities