Job Summary

• Develops and implements strategy aimed at increasing enterprise clinician capacity, enhancing clinician recruitment, development, and retention, and supporting clinician licensure compliance and continuing education.
• Provides enterprise leadership and oversight for Utilization Management (UM) policy governance, including UM Committee functions and UM letters, ensuring compliant and scalable application of UM standards across programs.
• Partners with clinical, compliance, legal, operations, and process improvement leaders to ensure governance decisions are operationalized across markets.

Matching Summary

Salary

Base: $126,300 - $173,700 per year; Bonus/Equity: Bonus incentive plan based on company and/or individual performance; Benefits: Medical, dental, vision, 401(k), time off, disability, life insurance, and more

Skills & Requirements

Key Requirements

• Bachelor's degree in healthcare administration, public health, business administration, or related field
• 3+ years direct management experience
• 5+ years experience in healthcare operations, utilization management, policy governance, or related areas
• Strong knowledge of Medicaid, NCQA, CMS, and state regulatory requirements
• Demonstrated experience leading cross-functional projects or governance initiatives

Work Rights