Lead cross-functional implementations with project plans, stakeholder engagement, and on-time delivery.
Analyze data and metrics to assess performance and mitigate risk.
Collaborate with stakeholders to interpret/apply evolving regulations across UM.
Coordinate UM regulatory requests: exams, URA filings, renewals, MHPAEA.
Oversee NCQA deliverables for UM standards.
Mentor teammates and promote growth and professional development.

🎯 Requirements

Bachelor's degree or 3+ years of related experience.
3+ years in healthcare Utilization Management or related field.
2+ years in regulatory compliance activities (MHPAEA, NCQA, licensing).
2+ years leading end-to-end project management or process improvement.
2+ years in regulatory implementation and compliance.
2+ years designing workflows and implementing procedures.

🎁 Benefits

Medical, dental, and vision benefits
Unlimited vacation policy
Annual performance bonuses

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