Utilization Management Analyst - job 1 of 2

Job Summary

A company is looking for an Analyst, UM.

Key Responsibilities

• Serve as the subject matter expert for configuration in the prior authorization (PA) system and report on PA-related information
• Maintain and audit prior authorization benefit designs, ensuring compliance with regulatory requirements
• Implement new client prior authorization benefit designs and support capacity planning for systems and software

Required Qualifications

• College degree in a science or business-related field, CPhT, or at least 2 years' experience in a related field
• Experience in working across multiple departments with technical and business acumen
• Prior experience with Prior Authorization or within a PBM preferred
• Intermediate to expert knowledge of the Microsoft Office Suite
• Knowledge of Medicare D regulatory requirements required prior to or soon after hire