Utilization Management QA Analyst

Job Summary

A company is looking for a UM QA for Utilization Management.

Key Responsibilities

• Perform QA audits on prospective and concurrent reviews of various healthcare services to ensure documentation accuracy and process quality
• Develop and deliver targeted education for the team regarding policies and procedures
• Assist in monitoring initiatives and outcomes to ensure goal attainment within defined parameters

Required Qualifications

• 2+ years of experience in US Healthcare in utilization management and/or Quality Assurance review
• Experience with HealthEdge HRCM, JIRA, or Guiding Care is a plus
• Strong knowledge of existing software packages (PowerPoint, Excel, Word, etc.)
• Ability to work independently and within a team environment
• Flexibility and ease with changing tasks and priorities