Director of Utilization Management

4 days ago


Orange, California, United States Alignment Healthcare Full time
Job Title: Director, Utilization Management

Alignment Healthcare is seeking a seasoned Director, Utilization Management to lead our clinical services operations. As a key member of our leadership team, you will be responsible for providing strategic direction and oversight to our utilization management functions across all markets.

Key Responsibilities:
  • Develop and implement strategies to improve population health, patient experience, and healthcare costs.
  • Lead a team of clinical professionals to ensure high-quality care management and utilization review processes.
  • Collaborate with cross-functional teams to identify and implement process improvements.
  • Develop and maintain relationships with key stakeholders, including physicians, hospitals, and payers.
  • Monitor and analyze key performance metrics to inform business decisions.
Requirements:
  • 5-6 years of experience in clinical services and/or health plan care management functions.
  • Significant experience in case management, utilization management, and population health.
  • Proven ability to use medical management metrics and develop data-driven initiatives.
  • Strong leadership and communication skills.
What We Offer:
  • A dynamic and growing organization with a mission to transform healthcare for seniors.
  • A collaborative and supportive work environment.
  • Opportunities for professional growth and development.

Alignment Healthcare is an Equal Opportunity/Affirmative Action Employer. We welcome applications from diverse candidates and are committed to creating an inclusive work environment.



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