Product Manager - Utilization Management

Company :

Highmark Health

Job Description : 

JOB SUMMARY

*If located within a 50 mile radius of a Highmark office in PA, DE, WV or NY this is a hybrid role requiring 3 days in office

*Note additional detail in Preferred Experience section

This job defines the product’s fundamental value proposition, outlines vision and execution plan, gains alignment and support from key strategic partners and stakeholders, and oversees execution of that vision. This incumbent will attend sprint/milestone reviews with the Delivery team.

ESSENTIAL RESPONSIBILITIES

• Understand the department's and the company's strategic roadmap and competitive position, and develops a holistic product vision and the corresponding product strategy to drive maximum value. Clearly set and communicate roadmaps, priorities, experiments, and decisions across audiences, from product team to executive levels.

• Actively anticipates future needs and utilizes metrics and qualitative input to identify asset improvement opportunities.

• Represent the product in all governance meetings.

• Clearly sets and communicates roadmaps, priorities, experiments, and decisions across audiences, from product team to executive levels.

• Serve as accountable owner for the sets of products/tools within the designated portfolio.

• Identify and drives both cross-product and cross-customer value and shared learnings.

• Own the product backlog and uses input from internal and partner teams to frequently refresh and re-prioritize the backlog.

• Other duties as assigned.

EDUCATION

Required

• Bachelor's Degree in science, technology, mathematics or related field OR relevant experience and/or education as determined by the company in lieu of bachelor’s degree

Preferred

• None

EXPERIENCE

Required

• 3 years of Product experience

To Include:

• 3 years with the Software Lifecycle

• 1 year of Advanced domain experience

Preferred

• 1 year with the Agile process

• Relationship & Stakeholder Management:

• Stakeholder Management: Experience in building and maintaining strong relationships with internal and external stakeholders, including clinical leaders, IT teams, and vendors.

• Analytical & Problem-Solving Acumen:

• Analytical and Critical Thinking: Demonstrated ability to analyze complex data, identify trends, and develop innovative solutions to improve product performance.

• Problem-Solving: Ability to identify, analyze, and resolve complex issues related to product development and implementation.

• Data Interpretation & Visualization: Ability to translate data insights into compelling visuals and reports for executive-level consumption.

• Presentation Skills: Exceptional presentation and communication skills, with the ability to effectively present complex information to diverse audiences, including executives, clinicians, and technical teams.

• Demonstration Skills: Proven ability to deliver engaging and informative product demonstrations and walkthroughs.

•  Utilization Management & Clinical Expertise:

• Utilization Management Knowledge: A strong understanding of utilization management principles, processes, and industry best practices.

• Clinical Knowledge: Familiarity with medical terminology, healthcare delivery systems, and clinical guidelines relevant to utilization management.

• Healthcare Industry Experience: Previous experience working in the healthcare industry, with a focus on utilization management or related areas

• Communication & Presentation Proficiency:

• Presentation Skills: Exceptional presentation and communication skills, with the ability to effectively present complex information to diverse audiences, including executives, clinicians, and technical teams.

• Demonstration Skills: Proven ability to deliver engaging and informative product demonstrations and walkthroughs.

•  Utilization Management & Clinical Expertise:

• Utilization Management Knowledge: A strong understanding of utilization management principles, processes, and industry best practices.

• Clinical Knowledge: Familiarity with medical terminology, healthcare delivery systems, and clinical guidelines relevant to utilization management.

• Healthcare Industry Experience: Previous experience working in the healthcare industry, with a focus on utilization management or related areas.

LICENSES or CERTIFICATIONS

Required

• None

Preferred

• None

SKILLS

• Business Acumen for P&Ls

• Communication

• Conflict Management

Language (Other than English):

None

Travel Requirement:

0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Office-based

Teaches / trains others regularly

Frequently

Travel regularly from the office to various work sites or from site-to-site

Occasionally

Works primarily out-of-the office selling products/services (sales employees)

Never

Physical work site required 

Yes

Lifting: up to 10 pounds

Constantly

Lifting: 10 to 25 pounds

Rarely

Lifting: 25 to 50 pounds

Never

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times.  In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. 

Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Pay Range Minimum:

$86,400.00

Pay Range Maximum:

$138,600.00

Base pay is determined by a variety of factors including a candidate’s qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations.  The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.

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