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UM Program Operations Manager
Job in
Newark, Essex County, New Jersey, 07175, USA
Listed on 2026-03-05
Listing for:
Virtual Vocations Inc
Full Time
position Listed on 2026-03-05
Job specializations:
-
Management
Healthcare Management
Job Description & How to Apply Below
Key Responsibilities Lead execution and refresh cycles for "Gold Card" and "Provider Incentive" programs, managing provider criteria and clinical audits Own the "Source of Truth" for the Prior Authorization list, ensuring compliance and accurate updates across systems Ensure all UM programs meet state and federal mandates and develop Standard Operating Procedures for new initiatives
Required Qualifications 4+ years of experience in program management 3+ years of experience in delivering projects/programs 2+ years of experience managing the prior authorization list process Experience in payer/health insurance Master's Degree or relevant certifications (PMP, Lean/Six Sigma) is a plus
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