Hybrid Senior Project Manager – Utilization Management

Posted 3 weeks ago

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About the role

  • 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)

Job title

Senior Project Manager – Utilization Management

Job type

Experience level

Senior

Salary

$122,900 - $188,020 per year

Degree requirement

Bachelor's Degree

Location requirements

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