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MEDICAL MANAGEMENT UTILIZATION ANALYST


 

The Utilization Management Analyst, (UMA) is responsible for managing operational processes related to utilization management of the MLTC benefit package including but not limited to Home Care, DME, and transportation. The UMA Collects and organizes information from multiple sources including patients, caregivers, and various clinical information systems, care management systems, and electronic health records. The UMA demonstrates the ability to identify appropriate available resources to address the needs of the member. The UMA collaborates with the clinical team to ensure timely authorization entry in the UM system meeting regulatory guidelines and ensuring provision of member services in accordance with departmental guidelines. The UMA Interfaces with and acts as a resource to team members, other MMC and CMO departments, members/caregivers and physicians/providers.

 

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: 94577 

 

Montefiore is an equal employment opportunity employer. Montefiore will recruit, hire, train, transfer, promote, layoff and discharge associates in all job classifications without regard to their race, color, religion, creed, national origin, alienage or citizenship status, age, gender, actual or presumed disability, history of disability, sexual orientation, gender identity, gender expression, genetic predisposition or carrier status, pregnancy, military status, marital status, or partnership status, or any other characteristic protected by law. 

 

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