Product Manager, Utilization Management

Job Summary

A company is looking for a Product Manager specializing in Utilization Management.

Key Responsibilities

• Develop and enhance Utilization Management solutions, focusing on prior authorizations and medical necessity reviews
• Serve as a subject matter expert for data reporting and client-specific opportunity analysis
• Support cross-functional teams by providing product demos, training, and analytics-driven insights

Required Qualifications and Education

• Experience in Utilization Management operations; clinical background preferred
• Strong understanding of prior authorizations and payer policies
• Hands-on experience with reporting tools like Tableau
• Knowledge of EHRs and claims processing systems
• Experience with AI-driven solutions and understanding of value-based care models