Central California Alliance for Health is hiring a
Utilization Management Data Specialist

Summary

Join the Alliance as a Utilization Management Data and Coding Specialist in the Utilization Management Department. Reporting to the Utilization Management Manager - Authorizations and Transportation, this position performs routine data analysis, research, reporting, and project assistance in support of Utilization Management Department programs.

Requirements

• Current Certified Professional Coder (CPC) issued by the American Academy of Professional Coders OR current Certified Coding Specialist - Physician Based (CCS-P) issued by the American Health Information Management Association
• Some experience with data analysis or supporting program data in a healthcare setting
• Demonstrated experience taking initiative, being resourceful to figure things out and has an aptitude to learn and incorporate new things as they come up
• Knowledge of: The principles and practices of medical coding and methodologies
• Knowledge of: The principles and practices of internal data auditing
• Knowledge of: Research, analysis, and reporting methods
• Knowledge of: Medical terminology including procedures and diagnoses coding
• Knowledge of: Working knowledge of the healthcare industry
• Ability to: Learn and utilize Alliance information systems
• Ability to: Enter, proofread, verify, analyze, and audit data
• Ability to: Review data to ensure data integrity and quality and to identify data anomalies
• Ability to: Produce organized, accurate, and detail-oriented work and maintain accurate records
• Ability to: Act as a technical resource and explain policies, regulations, terms, and procedures related to area of responsibility
• Education and Experience: Current Certified Professional Coder (CPC) issued by the American Academy of Professional Coders or current Certified Coding Specialist - Physician Based (CCS-P) issued by the American Health Information Management Association
• Education and Experience: Bachelor’s degree in Healthcare, Business or a related field
• Education and Experience: A minimum of three years of experience performing data analysis or related program support in a healthcare environment, which included some medical coding experience (a Master’s degree may substitute for two years of the required experience); or an equivalent combination of education and experience may be qualifying

Responsibilities

• Performs routine data analysis, research, reporting, and project assistance in support of Utilization Management Department programs
• Performs monitoring and maintenance of the departmental coding system to ensure data integrity and acts as the Utilization Management Department medical coding subject matter expert

Benefits

• Medical, Dental and Vision Plans
• Ample Paid Time Off
• 12 Paid Holidays per year
• 401(a) Retirement Plan
• 457 Deferred Compensation Plan
• Robust Health and Wellness Program
• Onsite EV Charging Stations