Utilization Management Operations Manager
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Job Location:
Monthly Salary:
Posted on:
24-10-2025
Vacancies:
1 Vacancy
Job Summary
At Collective Health were transforming how employers and their people engage with their health benefits by seamlessly integrating cutting-edge technology compassionate service and world-class user experience design.
The Utilization Management (UM) Operations Manager plays a critical role in the successful operationalization and ongoing support of Collective Healths UM program. This position is responsible for developing implementing and maintaining efficient UM processes ensuring regulatory compliance and providing vital support as the program scales. This is an individual contributor role focused on execution and optimization.
What youll do:
- Operational Implementation and Support:
- Develop document and implement efficient UM operational workflows and procedures.
- Provide ongoing operational support for the UM program addressing inquiries and resolving issues in a timely manner.
- Support the scaling of the UM program by assisting with the implementation of new processes technologies and workflows.
- Collaborate with cross-functional teams to execute a seamless integration of UM operations with other departments this includes Compliance Product and Engineering Clinical etc.
- Coordinate with UM Program Manager to execute and ensure timely updates to PA lists & UM functions - training SOPs KB updates.
- Monitor and action applicable UM reporting
- Attend and participate in Clinical Operations and Client meetings
- Regulatory Compliance:
- Ensure UM operations are in compliance with all applicable laws and regulations.
- Assist in the development and implementation of policies and procedures to mitigate regulatory risk.
- Process Improvement:
- Continuously evaluate and identify opportunities to improve UM processes and workflows including vendor related workflows
- Implement process changes to enhance efficiency effectiveness and quality of UM services.
- Utilize data and analytics to support process improvement initiatives.
- Documentation and Reporting:
- Maintain accurate and up-to-date documentation of UM processes procedures and workflows.
- Develop and generate reports on UM performance metrics and operational activities.
To be successful in this role youll need:
- A Bachelors degree in healthcare administration business administration or a related field.
- A minimum of 5 years of experience in UM operations or a related healthcare operations role.
- Strong understanding of UM principles processes and regulations.
- Excellent analytical problem-solving and organizational skills.
- Strong written and verbal communication skills.
- Ability to work independently and collaboratively in a fast-paced environment.
- Experience with healthcare information systems and UM software is a plus.
Pay Transparency Statement:
This is a hybrid position based out of one of our offices: Plano TX or Lehi UT. Hybrid employees are expected to be in the office three days per week (Plano TX) or two days per week (Lehi UT). #LI-hybrid
The actual pay rate offered within the range will depend on factors including geographic location qualifications experience and internal addition to the salary you will be eligible for stock options and benefits like health insurance 401k and paid time off. Learn more about our benefits at UT Pay Range
Key Skills
- Six Sigma
- Lean
- Management Experience
- Process Improvement
- Microsoft Outlook
- Analysis Skills
- Warehouse Management System
- Operations Management
- Kaizen
- Leadership Experience
- Supervising Experience
- Retail Management
About Company
Collective Health offers the first integrated solution that empowers employers to administer plans, manage costs, and take care of their people—all in one place.
