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Utilization Management Auditor Jobs in Alabama (NOW HIRING)

Tuskegee University

... utilization. * Prepare financial, operational, compliance, scholarship, and endowment reports ... management, auditing, compliance, or a related field. * Experience with financial management ...

Talladega College

College Registrar

Talladega, AL · On-site

... records management, degree auditing, curriculum processing, graduation, and academic scheduling ... Course demand and utilization * Student success metrics * Translate complex institutional data into ...

Urology Centers of Alabama

Data Engineer

Homewood, AL · On-site

$107K - $128K/yr

Build and manage data warehouses, data marts, and structured datasets to support clinical ... Implement data validation, auditing, and reconciliation processes to ensure data integrity across ...

Talladega College

College Registrar

Talladega, AL · On-site

... records management, degree auditing, curriculum processing, graduation, and academic scheduling ... Course demand and utilization * Student success metrics * Translate complex institutional data into ...

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Utilization Management Auditor information

What is the difference between Utilization Management Auditor vs Utilization Review Nurse?

AspectUtilization Management AuditorUtilization Review Nurse
CredentialsTypically requires a nursing license, certifications like CCM or CUCLicensed Registered Nurse (RN), often with additional certifications
Work EnvironmentOffice-based, insurance companies, healthcare organizationsHospital, clinics, insurance companies, often in clinical settings
Primary FocusAuditing and reviewing utilization data for compliance and cost managementAssessing patient care needs and determining appropriate services

While both roles involve healthcare utilization, the Utilization Management Auditor primarily reviews data for compliance and cost efficiency, whereas the Utilization Review Nurse focuses on patient care assessments. Both require nursing credentials and work within healthcare or insurance settings, but their core responsibilities differ.

What are some common challenges faced by utilization management auditors and how can they be addressed?

Utilization Management Auditors often encounter challenges such as keeping up with constantly changing healthcare regulations and payer requirements, interpreting complex medical documentation, and ensuring compliance with both internal and external policies. To address these challenges, auditors should engage in ongoing professional development, collaborate closely with clinical and administrative teams for accurate information, and make use of robust audit tools and resources. Effective communication and a proactive approach to regulatory changes can help streamline the audit process and maintain high standards of accuracy.

What is a utilization management auditor?

A Utilization Management Auditor is a healthcare professional responsible for reviewing medical records, claims, and utilization data to ensure that healthcare services provided to patients are necessary, appropriate, and comply with established guidelines and policies. They help identify overuse, underuse, or misuse of medical resources and ensure regulatory compliance. Utilization Management Auditors work closely with healthcare providers, insurance companies, and regulatory agencies to improve the quality and cost-effectiveness of patient care.

What are the key skills and qualifications needed to thrive as a utilization management auditor?

To thrive as a Utilization Management Auditor, you need a strong background in healthcare administration, case management, and medical coding, often supported by a clinical degree or certification such as RN, LPN, or RHIA. Familiarity with utilization management software, electronic health records (EHRs), and regulatory standards like CMS guidelines is essential. Analytical thinking, attention to detail, and effective communication are crucial soft skills for identifying compliance issues and collaborating with healthcare teams. These skills ensure accurate audits, regulatory compliance, and optimal resource utilization within healthcare organizations.
What are popular job titles related to Utilization Management Auditor jobs in Alabama? For Utilization Management Auditor jobs in Alabama, the most frequently searched job titles are:
What job categories do people searching Utilization Management Auditor jobs in Alabama look for? The top searched job categories for Utilization Management Auditor jobs in Alabama are:
What cities in Alabama are hiring for Utilization Management Auditor jobs? Cities in Alabama with the most Utilization Management Auditor job openings:
Utilization Management Auditor jobs near you

Space Auditor - Senior - #833 with Security Clearance

Allen Integrated Solutions LLC

Huntsville, AL • On-site

Other

Posted 16 days ago

Job description

Space Auditor - Senior Location: Huntsville, AL TS/SCI REQUIRED/Current CI Poly Responsibilities: * Support the FLS Space Management Team in maintaining accurate space, occupancy, and utilization data. * Coordinate directly with Directorate and Office Space Coordinators, Site Chiefs, Building Managers, and other stakeholders involved in space allocation and facility use. * Gather, analyze, and coordinate customer space and occupancy requirements. * Conduct facility and site walks to validate existing conditions, seating assignments, occupancy levels, and personnel bed-downs. * Perform field measurements and verify room dimensions, layouts, and space configurations. * Update floor plans and seating allocations based on audit findings and facility changes. * Resolve spatial orientation, floor plan, and occupancy discrepancies within assigned facilities. * Develop and revise space layouts using AutoCAD and Revit. * Read and interpret blueprints, floor plans, architectural drawings, and facility documentation. * Maintain accurate accounting of space usage, capacity, occupancy, and vacancy. * Use ARCHIBUS Computer-Aided Facility Management software to update records and generate utilization reports. * Pull and analyze capacity, occupancy, vacancy, and utilization data from the ARCHIBUS database. * Assist government personnel in identifying and resolving immediate and future space planning and occupancy needs. * Support strategic space planning, occupancy planning, and facility planning initiatives. * Assist Space Planners in identifying gaps and discrepancies in 1450 and 1450-1 accountable spaces. * Assemble and analyze building usage information to support planning, reporting, and compliance processes. * Prepare written reports, presentations, and communications for senior leadership. * Facilitate internal, public, and stakeholder meetings or workshops when applicable. * Manage multiple projects and assignments simultaneously while prioritizing work in accordance with leadership expectations. * Perform space audits at facilities worldwide, including domestic and international travel, on a bi-monthly or quarterly basis or more frequently as required by the customer. Qualifications: * Active TS/SCI clearance with CI Polygraph * Bachelor's degree in Architecture, Interior Design, Facilities Management, Engineering, Planning, or a related field and 6+ years of experience or 10+ years of experience in lieu of a degree. * Experience supporting space management, occupancy planning, facility planning, space auditing, or a related function. * Prior experience using ARCHIBUS or a comparable Computer-Aided Facility Management system. * Proficiency with AutoCAD and Revit for reviewing, developing, or updating facility floor plans and space layouts. * Experience conducting space audits, facility assessments, occupancy validations, or personnel bed-down reviews. * Ability to perform field measurements and accurately document facility conditions. * Ability to read and interpret blueprints, architectural drawings, and floor plans. * Proficiency with Microsoft Office Suite, SharePoint, and Adobe products. * Strong analytical, organizational, and problem-solving skills. * Excellent written and verbal communication skills, including the ability to communicate with and prepare materials for senior leadership. * Strong customer service and stakeholder coordination skills. * Ability to manage multiple assignments and adapt to changing priorities. * Ability and willingness to travel domestically and internationally, including periodic overseas travel. Desired: * Experience with strategic space planning, occupancy planning, facilities planning, and workplace utilization analysis. * Familiarity with federal space accountability requirements, including 1450 and 1450-1 accountable spaces. * Experience maintaining space inventory, occupancy, and utilization data for large or geographically dispersed facility portfolios.

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