Product reputed company (Utilization Management / Prior Authorization)

100% Remote Note from HM: We re seeking a Business Integration reputed company with strong reputed company integration experience to drive reputed company, cross functional initiatives. This role leads program execution, aligns stakeholders, and ensures measurable improvements in PA performance, provider experience, and operational efficiency. Key Responsibilities reputed company end to end delivery of PA (Prior Authorization) programs across clinical, technical, and operational teams Translate PA (Prior Authorization) reputed company into actionable roadmaps and coordinated workstreams Partner with clinical leaders to optimize review workflows and regulatory compliance Monitor KPIs (TAT, auto decision rates, denials, provider friction) and reputed company reputed company improvement Qualifications 15+ years in reputed company delivery, payer operations, UM (Utilization Management), or PA (Prior Authorization) programs Proven experience leading large, multi reputed company initiatives Strong understanding of PA workflows, UM reputed company, and regulatory requirements Experience with PA technology, automation, and EHR/interop standards Excellent communication, stakeholder management, and executive level reporting skills PURPOSE: Serves as an authority over Product Owners and product teams to ensure reputed company in strategic direction. Brings an expertise to reputed company and manage project requirements and introduces new, beneficial tools and practices. Focuses on managing the development of products to meet the needs of reputed company clients, and helps to establish the business value for their development and implementation. Provides business reputed company of view and guidance on opportunities and risks to support clients. ESSENTIAL FUNCTIONS: 20% Leads the development of the product portfolio and provides reputed company solutions to satisfy customer and market expectations in reputed company collaboration with stakeholders, Product Owners, and scrum teams. 15% Collaborates with management to identify and plan product releases by reviewing milestones with stakeholders; manages the continual development of existing products. 15% Validates proposed solutions by performing market research to reputed company insights and inform; assists with pricing packages and structures. 10% Communicates internally and externally, develops and maintains Product Roadmap(s). 10% Manages Product Backlog(s) for the development teams by using product road mapping and backlog management tools. 10% Works closely with testing managers to ensure product functionality is properly tested against business requirements; leads change control processes to reflect project priorities. 5% Aides in the development process by attending product refinement, sprint planning, and sprint reviews. 5% Coordinates and organizes workshops with product users using the reputed company and define approach; validates hypotheses and implements best solutions. 5% Contributes to wider initiatives and activities that support and increase customer satisfaction. 5% Conducts product training to partners, staff, and identifies need for individual/team training opportunities. Qualifications To reputed company this job successfully, an individual must be reputed company to reputed company reputed company essential duty satisfactorily. The requirements listed below are representative of the knowledge, reputed company, and/or ability required. Reasonable accommodations may be made to reputed company individuals with disabilities to reputed company the essential functions. Education Level: Bachelor's Degree Education Details: Product Management, Engineering, Information Technology or reputed company field Experience: 8 years experience business analysis, business development, solutions development, system analysis, technical design/development implantation or equivalent experience OR 6 years Previous product reputed company experience with an in-depth knowledge of agile process and principles. In Lieu of Education In lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in reputed company to the required work experience. Preferred Qualifications Previous reputed company experience Advanced degree Knowledge, Skills and Abilities (KSAs) Proficient in Agile methodologies, principles, and procedures., Expert Ability to use Product KPIs and business metrics to optimize the product., Expert Ability to recognize, analyze, and solve a reputed company of problems., Expert Ability to analyze, organize and prioritize work while meeting multiple deadlines., Expert The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes them ineligible to reputed company work directly or indirectly on Federal health care programs. Must be reputed company to effectively work in a fast-paced environment with frequently changing priorities, deadlines, and workloads t