ARE YOU AN APWU BARGAINING UNIT EMPLOYEE?

Join the APWU Health Plan team

APWU Health Plan is a great place to work. We offer a competitive salary, health insurance—including dental and vision—401(k), generous vacation leave, and tuition reimbursement.

Utilization Analyst

APWU Health Plan is seeking a Utilization Analyst to join our Utilization Management Department. This position assures the Health Plan remains competitive by identifying, designing, recommending, implementing and evaluating healthcare programs that control utilization and benefit expense.

RESPONSIBILITIES

  • Identify and seek out potential programs and vendors that support utilization management and make recommendations to senior staff on initiatives and strategies that support the corporate mission.
  • Advise on industry trends and identifie the need for new or revised utilization management programs and practices.
  • Direct quarterly trend reviews and forecasting analysis.
  • Other duties as assigned.

REQUIREMENTS

  • BA/BS degree and three to five year’s health insurance experience.
  • LPN or RN certification preferred.
  • Ability to define data and information needs; compile, analyze and interpret data relative to healthcare utilization.
  • Ability to write reports, recommendations, business correspondence, scope of work, project plans, policies and procedures. Ability to effectively present information to Health Plan Management and effectively communicate with vendor/partners and members.
  • Experience with medical benefit management and plan design, pharmacy benefit management and plan design, medical coding, medical and behavioral case management, familiarity with medical and pharmaceutical policies and industry standards.
  • Detail-oriented with strong analytical, presentation and research skills a must.
  • Strong performance management skills in managing external partners, communicating clear goals, performance measurements, etc.
  • Demonstrated ability to identify problems, collect data from various sources and determine the appropriate action.
  • Multi-disciplinary project management skills.
  • Excellent computer skills to include Microsoft Office, internet research and Ad hoc query and reporting.

We offer a competitive salary; health, dental, & vision insurance; 401(k); generous vacation leave; and tuition reimbursement. Please ensure all of the above requirements are clearly reflected in your resume or specifically addressed in your cover letter. Stated salary requirements (range is acceptable) are required for consideration. Experience in a Union environment preferred. No relocation assistance available. Must be COVID-19 vaccinated, pass criminal records check and drug screening prior to employment.

Apply Now

EOE M/F/D/V; Drug-Free Employer


NOTE TO AGENCIES
We do not accept unsolicited resumes from third-party vendors. Only resumes received from contracted agencies/vendors will be considered. Unsolicited resumes sent to APWU Health Plan will not be recognized and such agency will have no recourse from APWU Health Plan.