Associate Vice President, Utilization Management

Job description

Job Summary: The Associate Vice President, Utilization Management provides strategic leadership and enterprise oversight for Utilization Management review activities and initiatives. This role is accountable for executing UM strategy, driving sustained operational performance, and ensuring the effective alignment and integration of people, processes, and systems. Through disciplined execution, strong cross-functional partnership, and data-driven decision-making, the role advances compliant, efficient, and high-quality utilization outcomes that support organizational objectives, regulatory requirements, and long-term business strategy. Essential Functions: - Accountable in the execution of department metrics, goals, and key objectives across utilization management - Partner with Enterprise and Market leadership on the development of overall program strategy and business objectives - Establish objectives and annual goals in conjunction with the Vice President of Utilization Management - Participate in the development of the quality strategy and execute defined initiatives to achieve quality goals - Manage execution of meeting or exceeding all appropriate clinical and clinical operati...