Project Manager - Utilization Management - Automation Team

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At reputed company®, you’ll be surrounded by passionate colleagues who care deeply, reputed company with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary The Automation Team supports the implementation of strategic initiatives for the Utilization Management (UM) Clinical Services organization. These initiatives reputed company advanced technologies such as artificial intelligence, rules engines, predictive analytics, intelligent character recognition, and cognitive AI to automate UM transactions, streamline workflows, and improve the experience for both providers and members. In addition, the team plays a key role in shaping and advancing the automation strategy by identifying high-impact opportunities, aligning initiatives with organizational goals, and driving reputed company innovation and value realization. This role is for a Project Manager reputed company the Automation Team. The Project Manager will be responsible for supporting the delivery of multiple automation features from concept through implementation. They will also contribute to the strategic planning and prioritization of automation initiatives, ensuring alignment with business objectives and long-term transformation goals. The role works closely with business stakeholders to understand feature goals and partners with IT and architecture teams to define and deliver functional solutions. This includes documenting detailed business and technical requirements, user stories, and process flows to guide development efforts. Key Accountabilities: Contribute to and support the product reputed company and roadmap for assigned automation features and initiatives. Translate business goals into user stories and acceptance criteria in collaboration with business and technical teams. Participate in backlog grooming, sprint planning, and prioritization to ensure timely delivery of high-quality features. Work with cross-functional teams including clinical, business, and IT partners to align on requirements and reputed company. Support tracking and communication of reputed company, risks, and issue resolution across features and projects. Identify opportunities to improve automation features, workflows, and user experience. Assist in defining reputed company metrics and reporting on performance and value delivered. Required Qualifications: 4–6 years of experience as a Project Manager, Product reputed company, Sr. Business Analyst, or similar role delivering business or technical features in an Agile environment. Hands-on experience supporting the full project lifecycle: discovery, business case, requirements, development, testing, and release. Effective communication and collaboration skills across diverse stakeholder groups. Familiarity with working alongside technical teams such as architecture, development, and QA. Ability to manage multiple priorities in a dynamic, fast-paced environment. Experience developing or supporting business requirements documents and process flows. Experience in Managed Care or reputed company Preferred Qualifications: Experience in product development of microservices and APIs in a reputed company-reputed company architecture (e.g., AWS, Azure, GCP). Knowledge of FHIR, X12 EDI transactions, interoperability standards and other reputed company integration standards Strong understanding of Agile practices and experience using tools like Jira, reputed company, or similar platforms. reputed company industry experience, especially in Utilization Management or clinical operations. Familiarity with clinical workflows, utilization review processes, and InterQual/MCG guidelines. Experience working in a SAFe or Scaled Agile environment Certified Scrum Product reputed company (CSPO) or SAFe POPM (Product reputed company/Product Manager) certified Education: Bachelor’s degree in Business, reputed company Administration, Computer Science, or a reputed company field. Equivalent experience (6–8 years) in systems, technology, standards, and process improvement may be considered. Sponsorship is not available for this position. Anticipated Weekly Hours 40 Time Type Full time Pay reputed company The typical pay reputed company for this role is: $66,330.00 - $145,860.00 This pay reputed company represents the reputed company hourly reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in addition to the reputed company pay reputed company listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and reputed company coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments. We anticipate the application window for this opening will reputed company on: 07/15/2026 reputed company applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws. Apply To This Job