MEDICAL MANAGEMENT UTILIZATION ANALYST

at  Montefiore Medical Center

Responsible for managing operational processes related to utilization management programs including but not limited to, inpatient and outpatient concurrent review, SNF, home care, radiology, etc. Collects and organizes information from multiple sources including patients, caregivers, physicians, clinical information systems and electronic health records. The Utilization Management Analyst (UMA) uses this information to make decisions regarding utilization of services and benefits and/or referral to other internal or external/ community based resources. Escalates issues in accordance with established protocols, policies and procedures. Interfaces with and acts as a resource to team members, other MMC and CMO departments, members/caregivers and physicians/providers.
High School diploma or GED required. Two years of managed care experience or an equivalent combination of training and experience in a healthcare or managed care setting is required. Preferred graduate from an accredited college or university with an Associates Degree in Health Care Administration, Business Administration, or another appropriate health or human services field.

Equipment Operation:

• MS Office, email, internet, Copier, Scanners
• Experience working within case/utilization management systems, data entry and typing
• Automatic phone distribution systems
• Familiarity with web-based information systems

Department: CMO Bargaining Unit: Non Union Campus: YONKERS Employment Status: Regular Full-Time Address: 200 Corporate Boulevard S, Yonkers
Shift: Day Scheduled Hours: 8:30 AM-5 PM Req ID: 221008 Salary Range/Pay Rate: $62,400.00 - $62,400.00
For positions that have only a rate listed, the displayed rate is the hiring rate but could be subject to change based on shift differential, experience, education or other relevant factors.
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Please refer the Job description for details