Quality and Utilization Management Specialist - Compliance Specialist

January 9

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Premier Inc.

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Premier Inc. is a leading healthcare improvement organization that focuses on revolutionizing the healthcare industry through innovative solutions. They offer a wide range of services including group purchasing, technology, consulting, advocacy, and solutions for supply chain, quality improvement, pharmacy, and population health. Premier Inc. leverages data analytics, applied sciences, and artificial intelligence to drive decisions and generate real-world outcomes. Their mission is to transform healthcare and maximize value-based care, aiming to improve quality, safety, and better manage costs in health systems. The company's collaborative approach and partnership with healthcare providers enable them to deliver measurable results and influence healthcare policies.

healthcare and healthtech

1001 - 5000 employees

Founded 1996

⚕️ Healthcare Insurance

🤖 Artificial Intelligence

📋 Description

• Owner of interdepartmental coordination of monitoring and preparing submissions for Utilization Review state licenses. • Conduct regulatory research for licensing and compliance. • Support quality improvement and utilization management initiatives. • Document and track all licensing requirements and application statuses. • Work with internal departments and vendors for timely completion of requirements. • Collaborate with management to develop quality assurance plans.

🎯 Requirements

• Years of Applicable Experience - 2 or more years • High School Diploma or GED (Required) • Demonstrated ability to assume responsibility for daily activities and projects without direct supervision, including working within time frames to meet deadlines. • Demonstrated experience with written communications and document preparation. • Demonstrated organizational skills with strong attention to detail and quality. • Experience with policy review, report development/gathering to support NCQA/URAC accreditations. • Experience in organization, tracking, and trending of information • Experience with Utilization Management Licenses (Nationwide) • Experience with internal auditing • Associate’s degree or equivalent experience in compliance

🏖️ Benefits

• Health, dental, vision, life and disability insurance • 401k retirement program • Paid time off • Participation in Premier’s employee incentive plans • Tuition reimbursement and professional development opportunities