What You’ll Do:

• Oversee projects to enhance UM processes like cost control, provider redirection, and workflow automation.
• Dive into medical utilization and claims data to spot trends, identify cost drivers, and find areas for improvement.
• Work closely with teams in UM, Medical, Operations, and more to execute projects and align strategies.
• Track key metrics like cost savings, authorization rates, and outlier detection trends.
• Implement and ensure compliance with UM policies for cost management while maintaining care quality.

Qualifications:

• Bachelor’s Degree in Healthcare Management, Business, Data Analytics, or related field.
• 3-5 years of experience in utilization management, healthcare operations, or project management.
• Strong analytical skills with a focus on data-driven decisions.
• Proficiency with project management tools (Asana, Jira, Trello) and data visualization (Power BI, Google Sheets).
• Excellent communication and stakeholder management skills.

Please refer to job description.