Utilization Analytics Specialist (Temp)

Kaiser Permanente; Downey (CA); On-site; USD 70,000 - 90,000; Part time

Benefits offered by this job

Health benefits

Job summary

Kaiser Permanente in Downey, CA is seeking a data management and analysis professional to coordinate and supervise data workflows for utilization management and related services. You will implement and refine data systems, ensuring accurate reporting and timely insights for various care programs.

Responsibilities include coordinating data collection, educating clinical and administrative staff on benefits and charges, and supporting claims review processes.

Qualifications

• Experience applying analytic techniques to hospital data.
• Strong analytic and verbal skills.
• Expertise with tracking, spreadsheets and mainframe-style systems.
• Knowledge of health plan benefits.
• Understanding of medical center operations and regional policy interpretation.
• Ability to work in a Labor/Management Partnership environment.

Responsibilities

• Coordinate and supervise data management, analyses and reporting for utilization management and related services.
• Provide timely utilization data and analytic support to internal teams and outside facilities staff.
• Educate patients, physicians and hospitals on covered benefits and charges.
• Assist members during claims review and coordinate authorized/non-authorized claims review.
• Document outside medical services and reinforce procedures for patients seen in outside emergency departments.
• May coordinate Air & Ground Transportation and Prospective Review Authorization Program.
• Coordinate and supervise claims and referral information.
• Provide information regarding member admissions to outside facilities.
• Maintain integrity of non-KFH utilization bed track system.
• Assist in scheduling patient appointments and coordinating care.

Skills

Analytic skills

Verbal communication

Data tracking

Spreadsheets

Mainframe experience

Health plan knowledge

Education

High School Diploma or GED

AA/BA preferred

Tools

Health data systems

Job description

Kaiser Permanente in Downey, CA is seeking a data management and analysis professional to coordinate and supervise data workflows for utilization management and related services. You will implement and refine data systems, ensuring accurate reporting and timely insights for various care programs.

Responsibilities include coordinating data collection, educating clinical and administrative staff on benefits and charges, and supporting claims review processes.