Sr Project Manager leading complex enterprise transformation initiatives within Healthfirst’s Utilization Management department. Delivering projects that drive operational accountability, cost efficiency, quality, compliance, and technology-enabled transformation.
Responsibilities
Lead end-to-end delivery of complex, enterprise-wide (UM transformation) initiatives focused on operational efficiency, program transformation, technology enablement, and performance improvement
Drive UM modernization efforts through implementation of AI, automation, and advanced analytics solutions to improve medical necessity determinations, throughput, and decision accuracy
Translate strategic objectives into actionable project plans with clear scope, timelines, financial targets, and measurable outcomes for the UM department
Manage a high-volume portfolio of projects with significant cross-functional and technology interdependencies, including operations, clinical, medical management, finance, compliance/regulatory, and IT teams
Establish and manage project governance, including executive steering committees, decision forums, and escalation pathways
Proactively identify and manage risks related to cost, scope, regulatory compliance, operational disruption, and change adoption
Track, validate, and report on financial and operational benefits, including cost savings, productivity gains, and return on investment
Ensure projects comply with healthcare regulations, internal controls, and quality standards.
Requirements
Bachelor’s degree from an accredited institution
Prior experience leading medium to large scale, complex projects within healthcare, health insurance, or other regulated environments
Strong executive presence with the ability to influence decisions and drive alignment across senior leaders and diverse stakeholder groups
Demonstrated expertise managing projects with significant operational and technology dependencies requiring analytical, communication, and problem-solving skills
Benefits
medical, dental and vision coverage
incentive and recognition programs
life insurance
401k contributions (all benefits are subject to eligibility requirements)
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