Demo

Program Manager, Utilization Management - 25-10

Hill Physicians Medical Group
San Ramon, CA Full Time
POSTED ON 2/23/2025
AVAILABLE BEFORE 5/20/2025

We're delighted you're considering joining us!

At Hill Physicians Medical Group, we're shaping the healthcare of the future : actively managed care that prevents disease, supports those with chronic conditions and anticipates the needs of our members.

Join Our Team!

Hill Physicians has much to offer prospective employees. We're regularly recognized as one of the "Best Places to Work in the Bay Area" and have been recognized as one of the "Healthiest Places to Work in the Bay Area." When you join our team, you're making a great choice for your professional career and your personal satisfaction.

DE&I Statement :

At PriMed, your uniqueness is valued, celebrated, encouraged, supported, and embraced. Whatever your relationship with Hill Physicians, we welcome ALL that you are.

We value and respect your race, ethnicity, gender identity, sexual orientation, age, religion, disabilities, experiences, perspectives, and other attributes. Our celebration of diversity and foundation of inclusion allows us to leverage our differences and capitalize on our similarities to better serve our communities. We do it because it's right!

Job Description :

In this key position, you will be responsible for the planning and execution of major projects of the Utilization Management and Case Management Department. This position involves the coordination, project tracking and implementation of multi-faceted UM / CM projects to support our managed care activities. This position reports directly to the Manager of Authorization Business Product and is an important position in the achievement of strategic and operational goals.

Responsibilities :

  • Formulate project plans end-to-end.
  • Tracking other related projects across the business and IT related.
  • Perform data analysis as needed. Collate findings and drive execution of recommendations in partnership with operations teams and vendor partners.
  • Develop individual work plans by setting project scope, defining tasks and objectives, setting deadlines, assigning responsibilities to key stakeholders, and procuring resources.
  • Drive operational enhancements.
  • Empower collaborative process improvement efforts.
  • Develop / run reports and analyzing trends.
  • Establish and implement project plans.
  • Facilitate collaboration and communication between functional groups.
  • Ensure goals are tracked and met.
  • Create optimal project schedules and manage tight budgets.
  • Creatively solve project issues and proactively mitigate risks.
  • Communicate and collaborate with cross-functional stakeholders from operators to executive leadership.
  • Effectively facilitates teams and manages relationships.
  • Develop and maintain comprehensive project documentation, including detailed project work plans, project summaries, and calendars.
  • Monitor and control work by measuring progress / risk and correcting course when activities go beyond scope, budget, or are not meeting goals and objectives.
  • Must be effective in managing timelines and deadlines for projects
  • Must consistently work to improve efficiencies within EPIC to automate UM Processes.

Required

  • Minimum of 3 years in MSO or Health plan related projects
  • Minimum of 3 experience with EPIC
  • Epic certified for Referrals & Authorizations
  • Proficient in Microsoft Excel, Microsoft PowerPoint
  • Ability to perform data analysis / research and summarize key findings in presentation.
  • Positive team player, Structured and detail-oriented thinker
  • Proven problem-solving skills and ability to translate status of the projects to the department
  • Familiarity and use of Project Management tools and formats
  • Preferred

  • Previous experience with Utilization Management (Concurrent and / or Prior Authorization)
  • Previous experience with MSO Network projects
  • EPIC Certified for Tapestry Essentials
  • Bachelor's degree in business, project management, or related field is preferred
  • Up to date knowledge of industry standards and methods
  • PMP or similar Project Management certification
  • Proficient in Visio
  • Additional Information

  • Up to date knowledge of industry standards and methods
  • PMP or similar Project Management certification
  • Salary Range

    90,000 - $119,000 Annual

    Hill Physicians is an Equal Opportunity Employer

    Salary : $90,000 - $119,000

    If your compensation planning software is too rigid to deploy winning incentive strategies, it’s time to find an adaptable solution. Compensation Planning
    Enhance your organization's compensation strategy with salary data sets that HR and team managers can use to pay your staff right. Surveys & Data Sets

    What is the career path for a Program Manager, Utilization Management - 25-10?

    Sign up to receive alerts about other jobs on the Program Manager, Utilization Management - 25-10 career path by checking the boxes next to the positions that interest you.
    Income Estimation: 
    $113,122 - $140,555
    Income Estimation: 
    $156,966 - $210,205
    Income Estimation: 
    $174,196 - $220,425
    Income Estimation: 
    $235,645 - $292,423
    Income Estimation: 
    $175,165 - $219,883
    Income Estimation: 
    $200,471 - $254,173
    Income Estimation: 
    $107,623 - $139,321
    Income Estimation: 
    $133,494 - $170,282
    Income Estimation: 
    $131,105 - $151,214
    Income Estimation: 
    $128,269 - $173,633
    Income Estimation: 
    $157,111 - $225,157
    Income Estimation: 
    $87,195 - $112,851
    Income Estimation: 
    $115,491 - $158,336
    Income Estimation: 
    $102,413 - $133,130
    Income Estimation: 
    $109,705 - $144,044
    Income Estimation: 
    $119,541 - $162,386
    Income Estimation: 
    $137,274 - $178,415
    Income Estimation: 
    $182,502 - $249,036
    Income Estimation: 
    $207,946 - $249,343
    Income Estimation: 
    $175,165 - $219,883
    Income Estimation: 
    $182,642 - $260,237
    View Core, Job Family, and Industry Job Skills and Competency Data for more than 15,000 Job Titles Skills Library

    Job openings at Hill Physicians Medical Group

    Hill Physicians Medical Group
    Hired Organization Address San Ramon, CA Full Time
    We're delighted you're considering joining us! At Hill Physicians Medical Group, we're shaping the healthcare of the fut...
    Hill Physicians Medical Group
    Hired Organization Address San Ramon, CA Full Time
    We’re delighted you’re considering joining us! At Hill Physicians Medical Group, we’re shaping the healthcare of the fut...
    Hill Physicians Medical Group
    Hired Organization Address Sacramento, CA Full Time
    We’re delighted you’re considering joining us! At Hill Physicians Medical Group, we’re shaping the healthcare of the fut...
    Hill Physicians Medical Group
    Hired Organization Address San Ramon, CA Full Time
    We're delighted you're considering joining us! At Hill Physicians Medical Group, we're shaping the healthcare of the fut...

    Not the job you're looking for? Here are some other Program Manager, Utilization Management - 25-10 jobs in the San Ramon, CA area that may be a better fit.

    Nurse Manager - Utilization Management

    Kaiser Permanente, Richmond, CA

    Medical Director Utilization Management

    Alameda Alliance for Health, Alameda, CA

    AI Assistant is available now!

    Feel free to start your new journey!