Program Manager, Consultant

Your Role

The Utilization Management (UM) Prior Authorization Intake team manages intake, prior authorization and concurrent review for all BCS lines of business . The Program Manager, Consultant will report to the Sr. Manager, Utilization Management Intake & Operations. In this pivotal role, you will be responsible for leading and supporting strategic projects/initiatives and operational execution in UM Intake operations for the Commercial, Medi-Cal and Medicare lines of business.

Your Knowledge and Experience

• Requires a bachelor's degree or equivalent experience

• Requires at least 7 years of prior relevant experience

• 7 years of experience with Utilization Management, Commercial, Medicare and Medi-Cal lines of business is required

• 3 years of experience with Prior Authorization and Hospital Admission Intake is required

• Experience working with project and business change readiness preferred

• Experience with cross-functional coordination, UM operations, claims and provider networks is required.

• Proficient with Microsoft Office applications including Word, Excel, PowerPoint and Outlook.