• Audit Utilization Management (UM) Processes • Review and assess all aspects of the UM lifecycle, including intake, authorization creation, clinical decision making, correspondence, documentation, timeliness, and audit-readiness • Conduct audits of organization determinations and reviews for accuracy, quality, completeness, and timely decision-making • Monitor and audit workflows for intake and authorization activities • Identify systemic issues that may affect UM compliance or audit readiness and recommend corrective actions • Compile audit findings into detailed reports and provide actionable recommendations for improving processes • Maintain clear and accurate records of audit results • Ensure all audits align with internal and external compliance requirements