
Utilization Management Program Senior Assistant Manager
2 days ago
Duties & Responsibilities
Demonstrably optimize healthcare utilization for enrolled clients, achieving cost savings and improved member health outcomes through a robust Utilization Management Program.
Develop and Implement Client-Specific Utilization Management Strategies
Enhance Prior Authorization and Concurrent Review Processes
Strengthen Case Management and Disease Management Programs
Implement High-Cost Claimant Management
Continuously refine and implement innovative Utilization Management initiatives to ensure program effectiveness and client alignment.
- Research and Pilot New UM Technologies and Methodologies
- Conduct Regular Program Effectiveness Reviews
- Tailor Utilization Management Programs to Evolving Client Needs and Market Trends
- Integrate Behavioral Health and Physical Health Utilization Management
Foster collaborative partnerships with stakeholders and ensure transparent communication to maximize UM program adoption and success.
- Establish Strong Internal Collaboration Channels
- Develop and Maintain Provider Relationships
- Enhance Client Communication and Reporting
- Promote Member Engagement in Utilization Management Programs
Proactively monitor and evaluate Utilization Management program performance, driving continuous improvement through data-driven insights and feedback.
- Develop Robust Data Analytics and Reporting Frameworks
- Conduct Regular Performance Reviews and Deep Dives
- Implement a Continuous Improvement Cycle
- Benchmark Against Industry Standards and Competitors
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Assistant Manager-Utilization Management
2 weeks ago
Makati City, National Capital Region, Philippines Maxicare Healthcare Corporation Full timeOverviewJoin to apply for the Assistant Manager-Utilization Management role at Maxicare Healthcare Corporation.ResponsibilitiesOversee and implement initiatives aimed at improving UM operations, including but not exclusive to provider redirection, cost control, and process automation.Identify inefficiencies in UM workflows and propose data-driven and process...
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Senior Manager Utilization Management Projects
24 hours ago
Makati City, National Capital Region, Philippines beBeeUtilization Full time ₱1,000,000 - ₱2,000,000Unlock Career Growth with a Senior Management RoleJob Description:We are seeking an experienced senior manager to spearhead our utilization management projects. As a seasoned professional, you will oversee and implement initiatives that enhance operational efficiency and drive business outcomes.Main Responsibilities:Develop and execute strategies to improve...
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Healthcare Utilization Manager
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Makati City, National Capital Region, Philippines beBeeUtilization Full time ₱800,000 - ₱1,200,000Job DescriptionThis role focuses on leading the implementation of initiatives aimed at enhancing UM operations, including provider redirection, cost control, and process automation.The ideal candidate will oversee projects aligned with company goals for medical utilization cost containment.Data Analysis & Performance TrackingWe are seeking an individual to...
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Lead - Utilization Management
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Makati City, National Capital Region, Philippines Maxicare Healthcare Corporation Full timeOverviewLead - Utilization Management role at Maxicare Healthcare CorporationResponsibilitiesIdentify urgent and priority operational business and utilization management issuesDesign, execute, and implement a team plan, together with Project Lead, innovative and pragmatic solutions aligned with the business's long-term strategic plansOversee and manage...
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Senior Utilization Management Expert
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Senior Clinical Program Manager
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Analyst-Utilization Management
2 weeks ago
Makati City, National Capital Region, Philippines Maxicare Healthcare Corporation Full timeOverviewJoin to apply for the Analyst-Utilization Management role at Maxicare Healthcare CorporationResponsibilitiesMeasure success through key performance indicators and other metricsProvide analysis and meaningful information supporting decision-making and action-planningAnalyze current processes and systems to identify inefficiencies and areas for...
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MSP Program Manager
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Senior Utility Operations Manager
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