Utilization Management Assistant
About The Position
The primary responsibility of the position is to maintain standard compliance and performance related utilization management data. Process of daily, weekly and monthly UM reports. Establishes and maintains efficient filing system in paper and electronic. Maintains Health Plan audit tools including distribution and collection of data and documentation. Assists in data collection for all Health Plan audits and in necessary compilation of data for NCQA, DMHC and CMS focused audits and unplanned audits of the delegated Medical Group as downstream providers. Performs other duties as assigned by immediate Supervisor UM Compliance Manager and in support of compliance timelines. Providence caregivers are not simply valued – they’re invaluable. Join our team at Providence Regional Medical Center Everett and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them. Providence Regional Medical Center Everett received the HealthGrades Distinguished Hospital Award for Clinical Excellence four years in a row.
Requirements
- Associate's Degree in Health care, business or related field preferred.
- Equivalent education/experience
Responsibilities
- Maintain standard compliance and performance related utilization management data.
- Process daily, weekly and monthly UM reports.
- Establish and maintain efficient filing system in paper and electronic.
- Maintain Health Plan audit tools including distribution and collection of data and documentation.
- Assist in data collection for all Health Plan audits and in necessary compilation of data for NCQA, DMHC and CMS focused audits and unplanned audits of the delegated Medical Group as downstream providers.
- Perform other duties as assigned by immediate Supervisor UM Compliance Manager and in support of compliance timelines.
Benefits
- Best-in-class benefits uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
Associate degree
