Utilization Management Specialist

Job Summary

A company is looking for a Specialist, Utilization Management.

Key Responsibilities

• Support the evolution of the Utilization Management program by identifying improvement opportunities
• Monitor vendor performance against contractual SLAs and collaborate on corrective action plans
• Facilitate issue resolution with health plan partners, vendors, and provider services teams

Required Qualifications

• Bachelor's Degree or equivalent combination of education and experience
• 2+ years of relevant experience in utilization management operations or healthcare operations
• Experience working with external vendors or health plans in a UM capacity preferred
• Working knowledge of utilization management principles and prior authorization processes
• Proficiency in SmartSheets, Microsoft Word/Excel, and PowerPoint