Quality And Utilization Management Specialist

Premier Foods

Remote
Base: $62,000 - $93,000; bonus/equity: not specifi...
Fully remote
Utilization review state licenses
Regulatory research
Quality improvement initiatives
The Quality and Utilization Management Specialist will be the owner of, and the primary individual responsible for interdepartmental coordination of monitoring and preparing submissions for initial and renewal of Utilization Review (UR) state licenses

Job Summary

  • The Quality and Utilization Management Specialist will be the owner of, and the primary individual responsible for interdepartmental coordination of monitoring and preparing submissions for initial and renewal of Utilization Review (UR) state licenses.
  • This position will also support the Sr. Director, Quality and Utilization Management in developing, implementing, monitoring and updating quality improvement and utilization management initiatives as well as policies, procedures and processes.
  • Employees also receive access to the following benefits: Health, dental, vision, life and disability insurance; 401k retirement program; Paid time off; Participation in Premier’s employee incentive plans; Tuition reimbursement and professional development opportunities.

Matching Summary

The Quality and Utilization Management Specialist will be the owner of, and the primary individual responsible for interdepartmental coordination of monitoring and preparing submissions for initial and renewal of Utilization Review (UR) state licenses.

Salary

Base: $62,000 - $93,000; Bonus/Equity: Not specified; Benefits: Health, dental, vision, life and disability insurance, 401k, PTO, incentive plans, tuition reimbursement

Skills & Requirements

Must-have

  • Utilization Review state licenses
  • regulatory research
  • quality improvement initiatives
  • utilization management initiatives
  • URAC and NCQA accreditation
  • documenting and tracking licensing

Nice-to-have

  • assume responsibility without supervision
  • collaborative business environment
  • critical thinkers
  • thirst to learn more

Key Requirements

  • 2 or more years of applicable experience
  • High School Diploma or GED
  • Associate’s degree or equivalent experience
  • CHC certification preferred
  • Experience with Utilization Management Licenses
  • Experience with NCQA/URAC accreditation

Work Rights

Not specified

Tailored Resume

Cover Letter