Utilization Management Auditor

A company is looking for a Utilization Management Auditor. Key Responsibilities Audit all stages of the Utilization Management process for compliance with internal policies and regulatory guidelines Evaluate cross-departmental workflows to identify systemic issues and recommend corrective actions Compile detailed audit reports with findings and actionable recommendations for process improvements Required Qualifications High school diploma or GED required; Bachelor's degree in a related field preferred 3-5 years of experience in healthcare operations, Utilization Management, or auditing roles In-depth knowledge of Utilization Management processes and healthcare regulations Certification in Healthcare Compliance (CHC) or similar certifications is highly desirable Experience in developing reporting systems related to audit activities

Mar 25, 2025 - 14:27

A company is looking for a Utilization Management Auditor. Key Responsibilities Audit all stages of the Utilization Management process for compliance with internal policies and regulatory guidelines Evaluate cross-departmental workflows to identify systemic issues and recommend corrective actions Compile detailed audit reports with findings and actionable recommendations for process improvements Required Qualifications High school diploma or GED required; Bachelor's degree in a related field preferred 3-5 years of experience in healthcare operations, Utilization Management, or auditing roles In-depth knowledge of Utilization Management processes and healthcare regulations Certification in Healthcare Compliance (CHC) or similar certifications is highly desirable Experience in developing reporting systems related to audit activities