Utilization Management Assistant

The primary responsibility of the position is to maintain standard compliance and performance related utilization management data. Process of daily, weekly and monthly UM reports. Establishes and maintains efficient filing system in paper and electronic. Maintains Health Plan audit tools including distribution and collection of data and documentation. Assists in data collection for all Health Plan audits and in necessary compilation of data for NCQA, DMHC and CMS focused audits and unplanned audits of the delegated Medical Group as downstream providers. Performs other duties as assigned by immediate Supervisor UM Compliance Manager and in support of compliance timelines.