Utilization Management Auditor
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
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
