Utilization Management Associate

Job Summary

A company is looking for an Associate, UM Regulatory Operations to join their Regulatory Operations team.

Key Responsibilities

• Lead the end-to-end management of cross-functional implementations/projects, ensuring timely completion and stakeholder engagement
• Evaluate departmental performance through data analysis and assist in developing metrics and mitigation strategies
• Collaborate with stakeholders to interpret and apply regulations, ensuring compliance within UM operations

Required Qualifications

• A bachelor's degree or 3+ years of relevant experience
• 3+ years of experience in healthcare Utilization Management operations or related fields
• 2+ years supporting regulatory compliance activities, including Mental Health Parity and market conduct exams
• 2+ years of end-to-end project management or process improvement experience
• 2+ years in regulatory implementation and compliance, with experience in workflow design and improvement