New Utilization Analysts Job in Downey, CA!
Position Title: Utilization Analysts

Position Number: 340754

Location: Downey, CA 90242

Position Type: Temporary

Required Skill Set:

MS Excel, Reporting, Scheduling

Position Description:

**C2C is not available**
**Only U.S. Citizens and those authorized to work in the U.S. can be considered as W2 candidates.**
Title: Utilization Analysts
Location: Downey, CA 90242
Duration, probably a year - this time is very uncertain to predict an end date

Must be able to work a flexible schedule.
4 Part Time openings
2 shifts a week and maybe more
Right now 8 hours/ shift may lead to 10 or 12 hr shifts
Shift To start 7:00am -3:30pm, 24/7 department - could move into varied shifts - would need to be open to other times, shifts
*Must be able to work a flexible schedule.*

Coordinates & supervises data management, analyses, & reporting for KFH utilization management, SCPMG, KFHP Outside Services management (i.e., day utilization at Outside facilities), & the Emergency Prospective Review Program & Air & Ground Transportation Program, using (implementing & refining) computerized data management systems & in manually maintained utilization data.
• Immediate need will be clerical.
• Medical terminology/healthcare experience
• Roles such as admitting clerks would possibly be a good fit.
• Should have reporting/scheduling experience
• High functioning
• Open to Redundant work
• Helping with clerical area
• Medical terminology
• Must have Excel exp
• Work off Excel Spreadsheets
• Maneuver multiple screens
• Using EPIC (EPIC experience is preferred but not required)
• Doing a lot of Follow ups

Essential Functions:
• Coordinates & supervises data & reporting needs, data collection process, & data processing issues & provides timely utilization data & analytic support
• Frequent contacts with other organizational units & outside facilities staff to obtain, verify and/or provide information, e.g., works with Regional Claims & outside hospitals to reconcile billing charges
• Answers inquiries & educate patients, physicians, & hospitals on covered benefits & charges
• Provides information & assistance to Health Plan members during claims review process & coordinates authorized & non-authorized claims review
• Documents outside medical services & reinforce procedures for patients seen in outside emergency department
• May coordinate & supervise Air & Ground Transportation & Prospective Review Authorization Program
• Coordinates & supervises claims & referral information
• Provides information regarding member admissions to outside facilities
• Maintain the consistency & integrity of the non-KFH utilization bedtrack computerized data management system

Basic Qualifications:
• High School Graduate required.
• Associate of Arts or Bachelor's Degree preferred.
• Previous experience applying analytic techniques and computer skills to hospital data.
• Strong analytic and verbal skills.
• Expertise with tracking, spreadsheets and graphic computer systems operating on PC mainframes.
• Knowledge of Health Plan Benefits.
• Understanding of Medical Center operations, complex health systems, with the ability to quickly grasp Regional policies, contract interpretation of out-of-plan medical services.

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Rose International is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender (expression or identity), national origin, arrest and conviction records, disability, veteran status or any other characteristic protected by law. Positions located in San Francisco and Los Angeles, California will be administered in accordance with their respective Fair Chance Ordinances.

Rose International has an official agreement (ID #132522), effective June 30, 2008, with the U.S. Department of Homeland Security, U.S. Citizenship and Immigration Services, Employment Verification Program (E-Verify). (Posting required by OCGA 13/10-91.)
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