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Utilization Management Analyst

8/26/2025

Remote

Job Summary

A company is looking for an Analyst, UM.

Key Responsibilities
  • Serve as the subject matter expert for configuration in the prior authorization (PA) system and report on PA-related information
  • Maintain and audit prior authorization benefit designs, ensuring compliance with regulatory requirements
  • Implement new client prior authorization benefit designs and support capacity planning for systems and software
Required Qualifications
  • College degree in a science or business-related field, CPhT, or at least 2 years' experience in a related field
  • Experience in working across multiple departments with technical and business acumen
  • Prior experience with Prior Authorization or within a PBM preferred
  • Intermediate to expert knowledge of the Microsoft Office Suite
  • Knowledge of Medicare D regulatory requirements required prior to or soon after hire

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