Business Analyst
Infinite Computer Solutions
Key Responsibilities Perform data analysis and reporting to identify cost-containment opportunities through utilization trends, claims data, and pharmacy data. Document, review, and optimize utilization management processes including intake, concurrent review, and appeals. Define business requirements for IT solutions and conduct user acceptance testing (UAT) for UM software. Ensure all UM processes comply with state/federal regulations and accreditation standards. Act as a liaison between clinical staff (nurses, medical directors) and IT/leadership, facilitating cross‑functional collaboration. Required Skills and Qualifications 3-5+ years of experience in utilization management, care management, or managed care settings. Strong SQL skills and experience with data visualization tools such as Tableau or Power BI. Proficiency with electronic health record systems (EHR/EMR). Deep understanding of healthcare coding (ICD‑10, CPT), claims, and insurance regulations. Bachelor’s degree in Healthcare Administration, Nursing, or a related field. RN or LPN license preferred for clinical data interpretation. #J-18808-Ljbffr Infinite Computer Solutions
Vacancy posted 3 days ago
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