Utilization Management Project Manager

Website HealthTECH Resources, Inc.

HealthTECH Resources is seeking a Utilization Management Project Manager for a contract position in CA. To be considered for this role you must have 5 or more years of Senior-level Managed Care program and project management experience within Claims, UM/CM, PBM, or Medicaid/Medicaid.

  • Start date: ASAP
  • Length of Engagement: Through 12/31/19
  • On-Site Work only (no remote)

Utilization Management Project Manager Primary Duties

  • Plans and oversees 90 day Utilization Management work plan to completion: documents identified scope and objectives; deliverables and established schedules and timelines; documents number of project resources and skill level of necessary resources; assigns work to the project team; monitors budget constraints and internal customer satisfaction levels with project status.
  • Provides technical advice and recommendations regarding the creation or modifications of policies, procedures, enhancements, and acquisition of information systems, software, and services to internal customers; advises on project feasibility and recommends solutions to business owners if projects have material deviations from the project plan.
  • Meets with internal customers to document and establish production goals, priorities, and major work schedules for information technology and utilization management projects.
  • Develops project plans and documents status of projects: including timelines, schedules, process work diagrams, data flows and resources.
  • Meets with customers such as UM, claims, appeals and grievances, QI and IT staff to establish production goals, priorities, and major work schedules.

Utilization Management Project Manager Skills and Experience

  • 5 or more years’ experience in Senior-level Managed Care program and project management within Claims, UM/CM, PBM, or Medicaid.
    • Demonstrated expertise leading complex, enterprise-wide IT and Utilization management project implementations.
    • Principles and practices of program development, implementation, management and evaluation.
    • Principles and practices of personnel management, training and supervision.
    • Knowledge of Utilization Management systems.
    • Experience working in a Healthcare Information Technology related role within a Managed Care setting.
  • 3 or more years’ experience in the following areas: information systems analysis, data analysis and mapping, and/or database knowledge.
  • Cognizant TriZetto CareAdvance (Utilization Management/Care Management) experience.

Why work here?

  • This organization enjoys a reputation for excellence throughout the region and beyond — this is a great opportunity to get involved high up on a great project at an award-winning health care system.
  • Recognized as one of the most technologically advanced healthcare organizations in the state of CA.
  • Imagine coming to work every day knowing you can help make a difference in ways that truly matter – not just to the bottom line, but to the health and well-being of your friends, neighbors, and community.

To apply for this job email your details to jobs@healthtechresourcesinc.com