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Regulatory Compliance and Utilization Review Specialist

2 months ago

Harrisburg, Pennsylvania, United States Albright LIFE Full time

Coordinator of Utilization Review and Compliance Standards

Albright LIFE is dedicated to assisting individuals in fulfilling their healthcare requirements within the community, promoting independence and well-being. As part of the Albright LIFE team, you will collaborate with a diverse group of healthcare professionals to deliver exceptional, coordinated services that empower participants to maintain their health and live safely at home.

With a commitment to making a positive impact, Albright LIFE is recognized as a certified Great Place to Work, providing an opportunity to cultivate a meaningful career. Together, we strive to enhance the lives of those we serve.

Albright LIFE offers competitive salaries and a comprehensive benefits package. This position supports a hybrid work environment, requiring local travel to LIFE Centers. Candidates must reside in Central Pennsylvania.

The Coordinator of Utilization Review and Compliance Standards at Albright LIFE is tasked with overseeing utilization review initiatives and managing reporting mechanisms to ensure adherence to regulatory requirements while improving participant outcomes. This role is essential in evaluating performance metrics, fostering interdisciplinary teamwork, and advocating for high-quality care within the PACE program.

Qualifications

  • Bachelor's degree in Nursing, Healthcare Administration, or a related discipline (Master's degree preferred).
  • A minimum of 3 years of experience in utilization review and quality reporting, ideally within a PACE program or comparable healthcare environment.
  • Strong analytical capabilities with the proficiency to interpret and communicate data effectively.
  • Experience with EHR systems, particularly MatrixCare.
  • Exceptional communication, organizational, and problem-solving abilities.
  • A dedication to delivering high-quality, person-centered care.

Additional Information

We are an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, age, national origin, disability status, genetic information, protected veteran status, or any other characteristic protected by law.