Quality and Utilization Management Specialist jobs in United States
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Premier Inc. · 1 day ago

Quality and Utilization Management Specialist

Premier Inc. is a healthcare management consulting company, and they are seeking a Quality and Utilization Management Specialist. This role is responsible for coordinating utilization review state licenses, supporting quality improvement initiatives, and ensuring compliance with accreditation standards.

Health CareHospitalMedical
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Comp. & Benefits
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H1B Sponsor Likelynote

Responsibilities

Documenting and tracking of all licensing requirements and application statuses
Work with internal departments and outside vendor(s), as applicable, for the timely completion and submission of licensing requirements
Coordinate with legal to monitor all state licensing requirements and implement changes as identified
Provide support in developing, implementing, monitoring and updating quality improvement and utilization management initiatives
Assist with implementing and maintaining RBUM policies, procedures and processes
Support quality improvement initiatives, including but not limited to: monitoring, auditing, and tracking of Utilization Management Program
Coordinate with other departments and assist as needed in performing/monitoring required UM internal audits
Collaborating with management to develop quality assurance plans, working with employees to implement the strategies, and reviewing documents for accuracy
Assists with URAC and NCQA accreditation program standards and surveys, as well as any other accreditation program as adopted by the company
Assist with client audits and routine compliance tasks
Other responsibilities as assigned by Stanson management

Qualification

Utilization Management LicensesNCQA/URAC accreditationInternal auditingRegulatory researchQuality improvement initiativesIndependent decision makingAttention to detailWritten communicationOrganizational skillsCollaboration

Required

2 or more years of applicable experience
High School Diploma or GED (Required)
CHC, preferred
Remain in a stationary position for prolonged periods of time
Be adaptive and change priorities quickly; meet deadlines
Attention to detail
Operate computer programs and software
Ability to communicate effectively with audiences in person and in electronic formats
Day-to-day contact with others (co-workers and/or the public)
Making independent decisions
Ability to work in a collaborative business environment in close quarters with peers and varying interruptions

Preferred

Demonstrated ability to assume responsibility for daily activities and projects without direct supervision, including working within time frames to meet deadlines
Demonstrated experience with written communications and document preparation
Demonstrated organizational skills with strong attention to detail and quality
Experience in organization, tracking, and trending of information
Experience with Utilization Management Licenses (Nationwide)
Experience with NCQA/URAC accreditation
Experience with internal auditing
Associate's degree or equivalent experience in compliance

Benefits

Health, dental, vision, life and disability insurance
401k retirement program
Paid time off
Participation in Premier’s employee incentive plans
Tuition reimbursement and professional development opportunities
Perks and discounts
Access to on-site and online exercise classes

Company

Premier Inc.

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Premier, Inc. is a leading technology-driven healthcare improvement company, providing solutions to two-thirds of all healthcare providers in the U.S.

H1B Sponsorship

Premier Inc. has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (20)
2024 (10)
2023 (25)
2022 (9)

Funding

Current Stage
Public Company
Total Funding
unknown
2025-09-22Acquired
2013-10-10IPO

Leadership Team

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Gregory Montano
Vice President/Senior Vice President, Technology and Financial Operations
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Bruce Radcliff
President of Supply Chain Services
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Company data provided by crunchbase