Utilization Management Business Analyst at Impresiv Health | Torre
Utilization Management Business Analyst
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Impresiv Health

Utilization Management Business Analyst

Impresiv Health
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(2.3K) info
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Full-time

Legal agreement: Contractor

Currency exchange and payroll taxes to be paid by:

Depends on the location of the candidate

Compensation
USD40k - 110k/year
Non-negotiable
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Hybrid (United States)
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Posted over 5 years ago

Requirements and responsibilities

• Develop and maintain reporting on client deliverables and key indicators regarding medical management functions including care management, and medical management (utilization management) to ensure contract requirements, federal and state laws and regulations, and national accreditation standards are met. • Responsible for evaluating and documenting clinical processes, including step actions and workflows to construct and enhance the clinical model of care. • Acts as subject matter expert for an assigned work stream unit - Intake, UM, CM, DM, Reporting or Appeals. • Assists in the documentation and gathering of detailed requirements and workflow processes and analysis. • Reviews current workflow and lead recommendations and defines requirements to build processes and forms needed to support the business in the new system. • Recommends and implements software based on best practices. • Generates new and existing UM reports on defined schedule and on an ad hoc basis. • Models new UM metrics or changes in methodology. • Perform various analysis and interpretation to link business needs and objectives for assigned function. • Support business initiatives through data analysis, identification of implementation barriers and user acceptance testing of various systems • Identify and analyze user requirements, procedures, and problems to improve existing processes • Perform detailed analysis on multiple projects, recommend potential business solutions and ensure successful implementations • Works collaboratively with various levels of clinical staff and Information Systems staff to clarify needs, prioritize requests, and recommend workflow enhancements. • Analyzes customer needs and identify system and procedural solutions to enhance the clinical practices. • Identifies opportunities to leverage technologies in areas that improve and promote the clinical agenda. • Performs gap analysis. • Coordinate with various business units and departments in the development and delivery of training programs
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