
Lead - Utilization Management
3 weeks ago
Lead - Utilization Management role at Maxicare Healthcare Corporation
Responsibilities- Identify urgent and priority operational business and utilization management issues
- Design, execute, and implement a team plan, together with Project Lead, innovative and pragmatic solutions aligned with the business's long-term strategic plans
- Oversee and manage post-implementation support to utilization management initiatives
- Provide analysis and meaningful information supporting decision-making and action-planning
- Collaborate and communicate with leadership and cross-functional teams to understand the organization's goals and objectives
- Proactively interact and communicate with internal and external partners and stakeholders (Sales, Marketing, Operations, Finance, Audit, Provider Network, Claims ICT, etc) and build productive working relationships with key business partners
- Critically evaluate information gathered from multiple sources and reconcile data, effectively communicate information gathered/complex ideas to stakeholders
- People and team management including task assignments and ensuring team members' accountability on commitments; Coaching, mentoring, regular employee reviews, and supervising project timelines
- With at least 5 years of experience in performing data analytics and information management functions; with Commercial and Operational acumen
- Preferred industry orientation: Research and Data Management, Healthcare, Insurance, FMCG, or any service-oriented industry
- Graduate of Information Science, Math, Statistics, Industrial Engineering, or any business-related course
- Above average knowledge of Microsoft Excel/ Google Sheets and Microsoft PowerPoint/ Google Slides
- Knowledgeable in Python and/or R programming language is a plus
- Skills in data presentation/ visualization and analysis; Good analytical and verbal skills Curious, passion-driven, and enjoys numbers
- Strong analytical, problem-solving, and decision-making skills
- Planning Skills
- Critical Thinking
- Systems Thinking Mindset
- Financial Acumen
- Presentation and Communication Skills
- Collaboration and Cross-Functional Capability
- Competitive Intelligence
- Inspiring and Engaging
- Mid-Senior level
- Full-time
- Project Management and Information Technology
- Hospitals and Health Care
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