Job Description
This position is posted by Jobgether on behalf of a partner company. We are currently looking for an AVP, Utilization Management in the United States.
This senior leadership role is responsible for driving enterprise utilization management strategy and ensuring operational excellence across key clinical and revenue cycle processes. You will oversee programs focused on prior authorization, medical necessity review, and concurrent review while ensuring compliance with regulatory, payer, and CMS requirements. Operating at the intersection of clinical operations, finance, and revenue cycle performance, you will play a critical role in reducing preventable denials and improving reimbursement outcomes. The position requires strong executive leadership, strategic thinking, and the ability to influence large, cross-functional teams in a complex healthcare environment. You will also lead and develop operational leaders, shaping long-term organizational capability and performance. This is a high-impact role with visibility across enterprise stakeholders and responsibility for driving measurable improvements in care coordination and financial outcomes.
This position is posted by Jobgether on behalf of a partner company. We are currently looking for an AVP, Utilization Management in the United States.
This senior leadership role is responsible for driving enterprise utilization management strategy and ensuring operational excellence across key clinical and revenue cycle processes. You will oversee programs focused on prior authorization, medical necessity review, and concurrent review while ensuring compliance with regulatory, payer, and CMS requirements. Operating at the intersection of clinical operations, finance, and revenue cycle performance, you will play a critical role in reducing preventable denials and improving reimbursement outcomes. The position requires strong executive leadership, strategic thinking, and the ability to influence large, cross-functional teams in a complex healthcare environment. You will also lead and develop operational leaders, shaping long-term organizational capability and performance. This is a high-impact role with visibility across enterprise stakeholders and responsibility for driving measurable improvements in care coordination and financial outcomes.