Part-Time Utilization Analytics Specialist

Kaiser Permanente; Downey (CA); On-site; USD 39,000 - 83,000; Part time

Job summary

KAISER, located in Downey, CA, is seeking an Utilization Analyst-UHW to coordinate data management, analyses, and reporting for utilization management and related services. This role involves working with outside facilities, insurance steps, and incident reporting.

The position is part-time and temporary (approximately three months), requiring strong analytical and communication skills and familiarity with health plan benefits and mainframe/PC tools.

Qualifications

• Experience applying analytic techniques to hospital data.
• Strong analytic and verbal skills.
• Knowledge of tracking, spreadsheets and mainframe-oriented graphics tools.
• Knowledge of health plan benefits.

Responsibilities

• Coordinates and supervises data and reporting needs, data collection, data processing and provides timely utilization data and analytic support.
• Interacts with Regional Claims and outside hospitals to reconcile billing charges.
• Educates patients, physicians and hospitals on covered benefits and charges.
• Assists Health Plan members during claims review and coordinates authorization processes.
• Documents outside medical services and reinforces procedures for patients seen in outside ER.
• May coordinate Air & Ground Transportation and Prospective Review Authorization Program.
• Coordinates and supervises claims and referral information.
• Provides information regarding member admissions to outside facilities.
• Maintains non-KFH utilization bed track computerized data management system.
• Assists in scheduling patient appointments and coordinating patient care.

Skills

Analytic techniques

Verbal communication

Data tracking & spreadsheets

Health plan knowledge

Medical center operations

Labor/Management environment

Education

High School Diploma or GED

Associate or Bachelor degree (preferred)

Tools

Health Connect (preferred)

Mainframe experience

Job description

KAISER, located in Downey, CA, is seeking an Utilization Analyst-UHW to coordinate data management, analyses, and reporting for utilization management and related services. This role involves working with outside facilities, insurance steps, and incident reporting.

The position is part-time and temporary (approximately three months), requiring strong analytical and communication skills and familiarity with health plan benefits and mainframe/PC tools.