... utilization of risk assessment and risk prediction processes across our sites to ensure these are ... auditing / assessment skills • Strong document management skills and attention to details • ...
... utilization of risk assessment and risk prediction processes across our sites to ensure these are ... auditing / assessment skills • Strong document management skills and attention to details • ...
Service Delivery Manager
Mclean, VA · On-site
$146K - $234K/yr
... auditing, and reporting requirements * Financial and Resource Management * Supporting the program ... Tracking labor costs, productivity, and resource utilization to achieve desired outcomes, and ...
Service Delivery Manager
Mclean, VA · On-site
$146K - $234K/yr
... auditing, and reporting requirements * Financial and Resource Management * Supporting the program ... Tracking labor costs, productivity, and resource utilization to achieve desired outcomes, and ...
Service Delivery Manager
Mclean, VA · On-site
$146K - $234K/yr
... auditing, and reporting requirements * Financial and Resource Management * Supporting the program ... Tracking labor costs, productivity, and resource utilization to achieve desired outcomes, and ...
Service Delivery Manager
Mclean, VA · On-site
$146K - $234K/yr
... auditing, and reporting requirements * Financial and Resource Management * Supporting the program ... Tracking labor costs, productivity, and resource utilization to achieve desired outcomes, and ...
Service Delivery Manager
Mclean, VA · On-site
$146K - $234K/yr
... auditing, and reporting requirements * Financial and Resource Management * Supporting the program ... Tracking labor costs, productivity, and resource utilization to achieve desired outcomes, and ...
Service Delivery Manager
Mclean, VA · On-site
$146K - $234K/yr
... auditing, and reporting requirements * Financial and Resource Management * Supporting the program ... Tracking labor costs, productivity, and resource utilization to achieve desired outcomes, and ...
Service Delivery Manager
Mclean, VA · On-site
$146 - $234/hr
... auditing, and reporting requirements * Financial and Resource Management * Supporting the program ... Tracking labor costs, productivity, and resource utilization to achieve desired outcomes, and ...
Service Delivery Manager
Mclean, VA · On-site
$146 - $234/hr
... auditing, and reporting requirements * Financial and Resource Management * Supporting the program ... Tracking labor costs, productivity, and resource utilization to achieve desired outcomes, and ...
DATA ENGINEER
Reston, VA · On-site
$119K - $143K/yr
Designs, implements, and operates data management systems for intelligence needs Designs how data ... SQL, NoSQL, HPC, etc.), their configuration and utilization, and the optimization of the full data ...
DATA ENGINEER
Reston, VA · On-site
$119K - $143K/yr
Designs, implements, and operates data management systems for intelligence needs Designs how data ... SQL, NoSQL, HPC, etc.), their configuration and utilization, and the optimization of the full data ...
Assistant Controller
Henrico, VA · On-site
Medical
Dental
Vision
Retirement
... accuracy, optimize ERP utilization, and build a high-performing accounting team. Core ... Partner with external auditors and manage audit readiness, including timely and complete responses
Assistant Controller
Henrico, VA · On-site
Medical
Dental
Vision
Retirement
... accuracy, optimize ERP utilization, and build a high-performing accounting team. Core ... Partner with external auditors and manage audit readiness, including timely and complete responses
... utilization. This position will work proactively with plant management and operations managers to ... Provide leadership, training, and auditing on safety best practices, working conditions, and/or ...
... utilization. This position will work proactively with plant management and operations managers to ... Provide leadership, training, and auditing on safety best practices, working conditions, and/or ...
Accounting Manager
Tasley, VA · On-site
$55K - $75K/yr
This position is also responsible for assist-ing in the management of the agency's grant funds. In ... tion/utilization; • Prepare monthly financial statements and other reports as necessary for ...
Accounting Manager
Tasley, VA · On-site
$55K - $75K/yr
This position is also responsible for assist-ing in the management of the agency's grant funds. In ... tion/utilization; • Prepare monthly financial statements and other reports as necessary for ...
Operations Manager
Prince George, VA · On-site
... utilization. This position will work proactively with plant management and operations managers to ... Provide leadership, training, and auditing on safety best practices, working conditions, and/or ...
Operations Manager
Prince George, VA · On-site
... utilization. This position will work proactively with plant management and operations managers to ... Provide leadership, training, and auditing on safety best practices, working conditions, and/or ...
This position is also responsible for assist-ing in the management of the agency's grant funds. In ... Act as the liason for external auditors for the annual audit, preparing audit schedules and ...
This position is also responsible for assist-ing in the management of the agency's grant funds. In ... Act as the liason for external auditors for the annual audit, preparing audit schedules and ...
Service Delivery Manager with Security Clearance
Fairfax, VA · On-site
$146K - $234K/yr
Medical
Dental
Vision
Life
Retirement
PTO
... auditing, and reporting requirements * Financial and Resource Management * Supporting the program ... Tracking labor costs, productivity, and resource utilization to achieve desired outcomes, and ...
Service Delivery Manager with Security Clearance
Fairfax, VA · On-site
$146K - $234K/yr
Medical
Dental
Vision
Life
Retirement
PTO
... auditing, and reporting requirements * Financial and Resource Management * Supporting the program ... Tracking labor costs, productivity, and resource utilization to achieve desired outcomes, and ...
Medical Records Technician (Coder/Audit/Training)
Portsmouth, VA · On-site
$46K - $61K/yr
Perform limited utilization review of outpatient and inpatient records to assure the diagnosis ... Manager and Patient Administration Department Head for feed back to the providers. * Prepare ...
Medical Records Technician (Coder/Audit/Training)
Portsmouth, VA · On-site
$46K - $61K/yr
Perform limited utilization review of outpatient and inpatient records to assure the diagnosis ... Manager and Patient Administration Department Head for feed back to the providers. * Prepare ...
Medical Records Technician (Coder/Audit/Training)
Portsmouth, VA · On-site +1
$51K - $66K/yr
Perform limited utilization review of outpatient and inpatient records to assure the diagnosis ... Manager and Patient Administration Department Head for feed back to the providers. * Prepare ...
Medical Records Technician (Coder/Audit/Training)
Portsmouth, VA · On-site +1
$51K - $66K/yr
Perform limited utilization review of outpatient and inpatient records to assure the diagnosis ... Manager and Patient Administration Department Head for feed back to the providers. * Prepare ...
Cloud Engineer
Quantico, VA · On-site
$60 - $80.25/hr
... and manage core AWS services including EC2, S3, RDS, IAM, VPC, Lambda, CloudWatch, and related ... utilization using CloudWatch, CloudTrail, AWS Config, and related tools. • Support patching ...
Cloud Engineer
Quantico, VA · On-site
$60 - $80.25/hr
... and manage core AWS services including EC2, S3, RDS, IAM, VPC, Lambda, CloudWatch, and related ... utilization using CloudWatch, CloudTrail, AWS Config, and related tools. • Support patching ...
... and utilization of required measuring devices that correspond to the tasking in which they are ... Work directly with QAM, and Project Manager(s) to ensure all inspections requirements are properly ...
... and utilization of required measuring devices that correspond to the tasking in which they are ... Work directly with QAM, and Project Manager(s) to ensure all inspections requirements are properly ...
... and utilization of required measuring devices that correspond to the tasking in which they are ... Work directly with QAM, and Project Manager(s) to ensure all inspections requirements are properly ...
... and utilization of required measuring devices that correspond to the tasking in which they are ... Work directly with QAM, and Project Manager(s) to ensure all inspections requirements are properly ...
... and utilization of required measuring devices that correspond to the tasking in which they are ... Work directly with QAM, and Project Manager(s) to ensure all inspections requirements are properly ...
... and utilization of required measuring devices that correspond to the tasking in which they are ... Work directly with QAM, and Project Manager(s) to ensure all inspections requirements are properly ...
... and utilization of required measuring devices that correspond to the tasking in which they are ... Work directly with QAM, and Project Manager(s) to ensure all inspections requirements are properly ...
... and utilization of required measuring devices that correspond to the tasking in which they are ... Work directly with QAM, and Project Manager(s) to ensure all inspections requirements are properly ...
... and utilization of required measuring devices that correspond to the tasking in which they are ... Work directly with QAM, and Project Manager(s) to ensure all inspections requirements are properly ...
... and utilization of required measuring devices that correspond to the tasking in which they are ... Work directly with QAM, and Project Manager(s) to ensure all inspections requirements are properly ...
Utilization Management Auditor information
What is the difference between Utilization Management Auditor vs Utilization Review Nurse?
| Aspect | Utilization Management Auditor | Utilization Review Nurse |
|---|---|---|
| Credentials | Typically requires a nursing license, certifications like CCM or CUC | Licensed Registered Nurse (RN), often with additional certifications |
| Work Environment | Office-based, insurance companies, healthcare organizations | Hospital, clinics, insurance companies, often in clinical settings |
| Primary Focus | Auditing and reviewing utilization data for compliance and cost management | Assessing 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 Virginia? For Utilization Management Auditor jobs in Virginia, the most frequently searched job titles are:
What job categories do people searching Utilization Management Auditor jobs in Virginia look for? The top searched job categories for Utilization Management Auditor jobs in Virginia are:
What cities in Virginia are hiring for Utilization Management Auditor jobs? Cities in Virginia with the most Utilization Management Auditor job openings:
Mersen rating
7.3
Based on 15 frontline employees who took The Breakroom Quiz
102nd of 157 rated electronics manufacturers
Job description
Mersen is a global expert in electrical specialties and advanced materials for high-tech industries.
Present in 32 countries with 50 industrial sites and 24 R&D centres, Mersen develops custom solutions and supplies key products to meet the new technological challenges that will shape tomorrow's world.
For more than 130 years, Mersen has been constantly innovating to support and satisfy its customers' needs with the same high standards.
Be it in wind power, solar power, electronics, electric vehicles, aeronautics, space or countless other sectors, wherever technology is progressing, you will always find a bit of Mersen.
Main missions
EHS & CSR Specialist
Essential Functions
• Works with and through Mersen management structure and EHS&CSR team for all ACE USA sites (Salem, Gonzales, Louisville) to continuously improve safety systems that create a climate and culture in which safety is synonymous with operational excellence.
• Partners with leadership team to develop Site EHS&CSR key priorities, drivers, and activities with key performance indicators to drive Site EHS performance improvement.
• Manages corporate projects (CSR, Safety, Environment, Human) to ensure interaction with site management team, team leaders, and site employees to increase awareness and education levels regarding safe, social and compliant work.
• Leads the effective implementation and utilization of risk assessment and risk prediction processes across our sites to ensure these are effective at identifying and mitigating hazards and are effectively communicated and understood by all employees.
• Ensures investigation of all EHS related incidents to drive to root cause and identify actions to prevent recurrence.
• Provide safety coaching, mentoring, and guidance to employees and site leaders and provide active follow-up to resolve any safety concerns promptly.
• Develops EHS best in class programs, systems, and processes, including training and mentoring to establish clear procedures on EHS measures and precautions.
• Maintains Mersen's safety system, responsible for MSV audits, administrative reporting requirements, and additional EHS programs, policies, and procedures that are developed to include crisis response are maintained and current.
• Designs, implements, and continuously improves workplace EHS policies, programs, and procedures.
• Proactively seeks updates and changes to government regulations, guidance, and industry best practices that are applicable to Mersen's operations; continuously evaluates Mersen's program, policies, and procedures within the context of changes to government regulations, guidance, and industry best practices; implements complete solutions.
Main duties
Required Qualifications
• A bachelor's degree in a health, safety, or environmental field of study
• 3- 5 years' experience in health and safety.
• HSE Qualification such as OSHA General Certificate or equivalent
• In depth knowledge of legislation (e.g., OSHA/EPA/DOT) and procedures
• Strong problem solving/trouble shooting skills
• Strong auditing / assessment skills
• Strong document management skills and attention to details
• Proficient in all Microsoft Applications.
Knowledge, Skills & Abilities
• Demonstrated attributes to become a strong team player, eagerness to learn and grow, self-starter who takes initiative, versatile, and service oriented
• Excellent communications and interpersonal skills, with the ability to establish and maintain effective relationships with management teams, colleagues, and employees
• Able to perform with a high degree of independent judgement, discretion, and confidentiality
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status. The job titles do not mean the male variant but stand for the gender-neutral designation of the profession according to wikipedia. People are welcome regardless of gender, origin, sexual orientation, and religion.
Present in 32 countries with 50 industrial sites and 24 R&D centres, Mersen develops custom solutions and supplies key products to meet the new technological challenges that will shape tomorrow's world.
For more than 130 years, Mersen has been constantly innovating to support and satisfy its customers' needs with the same high standards.
Be it in wind power, solar power, electronics, electric vehicles, aeronautics, space or countless other sectors, wherever technology is progressing, you will always find a bit of Mersen.
Main missions
EHS & CSR Specialist
Essential Functions
• Works with and through Mersen management structure and EHS&CSR team for all ACE USA sites (Salem, Gonzales, Louisville) to continuously improve safety systems that create a climate and culture in which safety is synonymous with operational excellence.
• Partners with leadership team to develop Site EHS&CSR key priorities, drivers, and activities with key performance indicators to drive Site EHS performance improvement.
• Manages corporate projects (CSR, Safety, Environment, Human) to ensure interaction with site management team, team leaders, and site employees to increase awareness and education levels regarding safe, social and compliant work.
• Leads the effective implementation and utilization of risk assessment and risk prediction processes across our sites to ensure these are effective at identifying and mitigating hazards and are effectively communicated and understood by all employees.
• Ensures investigation of all EHS related incidents to drive to root cause and identify actions to prevent recurrence.
• Provide safety coaching, mentoring, and guidance to employees and site leaders and provide active follow-up to resolve any safety concerns promptly.
• Develops EHS best in class programs, systems, and processes, including training and mentoring to establish clear procedures on EHS measures and precautions.
• Maintains Mersen's safety system, responsible for MSV audits, administrative reporting requirements, and additional EHS programs, policies, and procedures that are developed to include crisis response are maintained and current.
• Designs, implements, and continuously improves workplace EHS policies, programs, and procedures.
• Proactively seeks updates and changes to government regulations, guidance, and industry best practices that are applicable to Mersen's operations; continuously evaluates Mersen's program, policies, and procedures within the context of changes to government regulations, guidance, and industry best practices; implements complete solutions.
Main duties
Required Qualifications
• A bachelor's degree in a health, safety, or environmental field of study
• 3- 5 years' experience in health and safety.
• HSE Qualification such as OSHA General Certificate or equivalent
• In depth knowledge of legislation (e.g., OSHA/EPA/DOT) and procedures
• Strong problem solving/trouble shooting skills
• Strong auditing / assessment skills
• Strong document management skills and attention to details
• Proficient in all Microsoft Applications.
Knowledge, Skills & Abilities
• Demonstrated attributes to become a strong team player, eagerness to learn and grow, self-starter who takes initiative, versatile, and service oriented
• Excellent communications and interpersonal skills, with the ability to establish and maintain effective relationships with management teams, colleagues, and employees
• Able to perform with a high degree of independent judgement, discretion, and confidentiality
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status. The job titles do not mean the male variant but stand for the gender-neutral designation of the profession according to wikipedia. People are welcome regardless of gender, origin, sexual orientation, and religion.
