Director, Utilization Management Operations
Employment Information
Report this job
Job expired or something wrong with this job?
Job Description
Utilization Management Operations Director scaling Devoted Health’s healthcare authorization operations. Leading teams, vendors, process redesign, and AI-enabled efficiency improvements.
Responsibilities:
- Own SLA performance for administrative steps supporting authorization review across utilization management
- Hold dotted-line accountability for Part B medical authorization turnaround times, partnering with clinical leaders to monitor performance, surface risks, and remove administrative barriers
- Map and redesign end-to-end administrative processes including authorization intake, clinical information requests, facility census checks, notifications, and follow-up
- Partner with Product and Engineering to shape the Orinoco technology roadmap
- Implement integrated AI tools to reduce manual effort and administrative capacity growth
- Design measurable and transparent processes and define and monitor KPIs including timeliness, cost per authorization, quality, and provider experience
- Lead and develop approximately 50 onshore UM Administrative Coordinators and their leaders
- Manage an offshore vendor partnership supporting more than 250 administrative team members
- Partner with Provider Network to incorporate provider and facility needs into the process
- Design member and provider outreach, notifications, and follow-up touchpoints
- Collaborate with the Senior Director of UM, UM Medical Directors, Compliance, Provider Network, Data Science, and Engineering teams
- Keep the operation aligned and consistently audit-ready
Requirements:
- Genuine commitment to treating members like family, and belief that operational excellence and empathy belong together
- Track record of leading high-volume operations that deliver consistent SLA performance
- Experience taking a complex, multi-step process apart and leading the build of a simpler, more scalable one
- Comfortable working deep in workflows and data and using both to drive decisions and accountability
- Experience partnering with product and engineering teams
- Genuine excitement about using AI-enabled tools to transform how work gets done
- Experience managing vendor partners against clear performance and quality standards
- Exceptional written and verbal communication skills
- Bachelor’s degree required
- Experience in payer operations, utilization management, claims, provider revenue cycle, or a similar high-volume healthcare environment is desired
- Understanding of Medicare Advantage operations and CMS requirements is desired
- MBA or advanced degree in health administration or finance is a plus
Benefits:
- Employer sponsored health, dental and vision plan with low or no premium
- Generous paid time off
- $100 monthly mobile or internet stipend
- Stock options for all employees
- Parental leave program
- 401K program
- Bonus eligibility for all roles excluding Director and above
- Commission eligibility for Sales roles
Similar Jobs
Trade Operations Manager – APAC
Trade Operations Manager overseeing APAC import-export and export-controls compliance for Cummins, a global power technology company. Reducing regulatory risk and costs across regional operations.
Operations Supervisor – Pre-Contract Ops Support
Supervisor de Operações coordenando projetos, processos e qualidade de IA pré-contrato. QuintoAndar simplifica jornadas de aluguel, compra e venda de imóveis na América Latina.
Care Operations Associate
Care Operations Associate guiding families from school referral to mental-health intake. Managing high-volume calls and improving Marble’s platform processes connecting families with licensed therapists.
Partner Operations Manager
Partner Operations Manager scaling partner onboarding, support, hardware, payments, and reporting. Building repeatable operations for robotics and embodied AI data infrastructure.
Operations Lead – Global
Operations Lead building automations, dashboards and AI workflows for a growing social-impact technology business. Partnering with the CEO on operations, compliance and leadership systems.
Associate, Market Operations
Market Operations Associate supporting DraftKings’ prediction markets through surveillance, settlement, and regulatory operations. Ensuring fair, compliant, liquid markets with engineering and exchange partners.
Lifecycle & CRM Operations Specialist
Lifecycle CRM specialist building and QAing Braze campaigns for Dave’s financial app. Ensuring accurate, compliant communications for over 14 million members.
Virtual Practice and Operations Manager
Virtual Operations Manager bridging athenaOne and Boulevard workflows for two Michigan medical practices. Overseeing staff, encounters, vendors, billing metrics, and executive reporting remotely.
DATEV Technician, Operations Manager
DATEV technician managing IT integrations, monitoring, and troubleshooting for Jessy Works’ AI-powered accounting automation platform. Coordinating Kanzlei administrators and system houses entirely remotely.
Technical Delivery & Operations Lead – Sportsbook Engineering
Technical delivery lead coordinating roadmap, operations, metrics, and AI adoption for Hard Rock Digital’s online sportsbook and gaming platform. Aligning engineering, product, and technology teams.
Director of Research Operations
Director leading day-to-day operations for Cardiovascular Associates of America’s multi-site clinical trials network. Building scalable processes, accountability, and performance visibility across sites and research teams.
Senior Operations Specialist
Senior Operations Specialist managing client onboarding, account operations, and trading support. Improving scalable processes for a growing Austin wealth management firm.
Exhibit Operations Specialist
Exhibit operations specialist managing fulfillment, floor plans, exhibitors, and invoicing for GBTA’s global business travel expos. Coordinating events, contractors, sales, marketing, finance, and exhibitors.
Operations Coordinator
Operations Coordinator supporting Veridapt’s mining fuel-management platform from the Philippines. Coordinating field-service scheduling, compliance, mobilisation, projects and partner administration.
Stagiair Strategy & Operations – Financial Sector
Strategy & Operations-stagiair bij KPMG voor Nederlandse financiële-sectorconsultancy. Meewerken aan strategie, operatingmodellen, presentaties en marktanalyses.
Campaign Operations Specialist
Campaign Operations Specialist building and optimizing AI-enabled marketing automation for Skillsoft, a global skills-management platform. Managing Pardot, Salesforce, nurture programs, segmentation, QA, and campaign insights.
Regional Operations Director
Regional operations leader overseeing P&L, performance, culture, and medical quality across 14 VCA veterinary hospitals in Atlanta. Coaching hospital leaders and driving sustainable growth.
Director, Corporate Development – M&A Integration, Operations
Corporate Development Director leading M&A diligence, integration, and portfolio operations. Building AI-enabled systems for CrowdStrike, a global cybersecurity company.
Senior Defined Benefit Operations Analyst – Operations Manager
Senior Defined Benefits operations analyst supporting Conduent’s pension administration services. Leading client changes, resolving system issues, and improving processing quality.
Data Center Operations Lead
Data Center Operations Lead managing Thales’ production data center and cloud infrastructure. Leading incidents, automation, security, and service reliability for global digital-security services.