Utilization Management Quality Reporting Specialist II

Job Summary

The Utilization Management (UM) Quality Reporting Specialist II is responsible for working with internal teams to support and ensure the effective implementation of regulatory and operational reporting requirements and related projects for L.A. Care’s Utilization Management Quality Assurance Team, independently and collaboratively managing assigned reporting components and project deliverables. This position ensures compliance with federal, state, and accreditation requirements.

Duties

Ensures successful completion of assigned quality projects related to regulatory and operational reporting, regulatory and accreditation audit readiness, and monitoring and oversight projects while working with UM department to support quality initiatives.

Conducts data validation to ensure integrity of regulatory and operational reports, audit universe preparation for regulatory and accreditation audits, works with management in ...