Kaiser Permanente · 4 hours ago
Utilization Analyst
Downey, CA
Full-time
Onsite
New Grad, Entry LevelKaiser Permanente is a healthcare organization seeking a Utilization Analyst to coordinate and supervise data management, analyses, and reporting for utilization management and Continuing Care Services. The role involves providing timely utilization data and analytic support while maintaining the integrity of the data management systems.
Health CareHospitalMental HealthNon ProfitPersonal Health
Responsibilities
Coordinates and supervises data and reporting needs, data collection process and data processing issues and provides timely utilization data and analytic support
Frequent contacts with other organizational units and outside facilities staff to obtain, verify and/or provide information, e.g., works with Regional Claims and outside hospitals to reconcile billing charges
Answers inquiries and educate patients, physicians and hospitals on covered benefits and charges
Provides information and assistance to Health Plan members during claims review process and coordinates authorized and non-authorized claims review
Documents outside medical services and reinforce procedures for patients seen in outside emergency department
May coordinate and supervise Air & Ground Transportation and Prospective Review Authorization Program
Coordinates and supervises claims and referral information
Provides information regarding member admissions to outside facilities
Maintain the consistency and integrity of the non-KFH utilization bed track computerized data management system
May assist in scheduling patient appointments and coordinating patient care
Qualification
Required
High School Diploma or General Education Development (GED) required
Experience applying analytic techniques and computer skills to hospital data
Strong analytic and verbal skills
Expertise with tracking, spreadsheets and graphic computer systems operating on PC mainframes
Knowledge of health plan benefits
Understanding of medical center operations, complex health systems, with the ability to quickly grasp regional policies, contract interpretation of out-of-plan medical services
Must be able to work in a Labor/Management Partnership environment
Preferred
Health Connect experience a plus
Associate of Arts or Bachelors degree preferred
KPHC - MEDICAL RECORDS, FOUNDATIONS / MAINFRAME EXPERIENCE
Company
Kaiser Permanente
Kaiser Permanente is a health organization that offers disease prevention, mental healthcare, and chronic disease management services.
Founded in 1945
10001+ employees
Funding
Current Stage
Late StageTotal Funding
$7.48M2018-07-17Grant· $0.08M
2014-08-05Grant· $7.4M
Leadership Team
Gregory Adams
Chair and Chief Executive Officer
James L. Robinson III
Senior Vice President/Area Manager
Recent News
2026-01-24
2026-01-23
2026-01-23
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