Director, Utilization Management Operations

Devoted Health

. Own SLA performance for administrative steps supporting authorization review across utilization management .

Posted 11/1/2026full-timeRemote • United StatesLead💰 $182,000 - $247,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in managing high-volume operations within utilization management, focusing on SLA performance, process redesign, and the integration of AI tools. Proven ability to lead teams, manage vendor partnerships, and ensure compliance in a healthcare environment.

Highest-signal resume keywords

SLA Performance ManagementProcess RedesignAI Tool ImplementationVendor Partnership ManagementHealthcare Operations Expertise

ATS Keywords

Tailor your resume

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Utilization ManagementProcess MappingKPI MonitoringData AnalysisWorkflow Optimization

Soft Skills

Exceptional Communication SkillsEmpathy in OperationsLeadership Development

Tools & Technologies

Orinoco TechnologyAI-Enabled Tools

Certifications & Qualifications

Bachelor's DegreeMBA or Advanced Degree in Health Administration or Finance

Industry Keywords

Payer OperationsClaims ManagementProvider Revenue CycleMedicare Advantage OperationsCMS Requirements

About the role

Key responsibilities & impact

Own SLA performance for administrative steps supporting authorization review across utilization management
Hold dotted-line accountability for Part B medical authorization turnaround times, partnering with clinical leaders to monitor performance, surface risks, and remove administrative barriers
Map and redesign end-to-end administrative processes including authorization intake, clinical information requests, facility census checks, notifications, and follow-up
Partner with Product and Engineering to shape the Orinoco technology roadmap
Implement integrated AI tools to reduce manual effort and administrative capacity growth
Design measurable and transparent processes and define and monitor KPIs including timeliness, cost per authorization, quality, and provider experience
Lead and develop approximately 50 onshore UM Administrative Coordinators and their leaders
Manage an offshore vendor partnership supporting more than 250 administrative team members
Partner with Provider Network to incorporate provider and facility needs into the process
Design member and provider outreach, notifications, and follow-up touchpoints
Collaborate with the Senior Director of UM, UM Medical Directors, Compliance, Provider Network, Data Science, and Engineering teams
Keep the operation aligned and consistently audit-ready

Requirements

What you’ll need

Genuine commitment to treating members like family, and belief that operational excellence and empathy belong together
Track record of leading high-volume operations that deliver consistent SLA performance
Experience taking a complex, multi-step process apart and leading the build of a simpler, more scalable one
Comfortable working deep in workflows and data and using both to drive decisions and accountability
Experience partnering with product and engineering teams
Genuine excitement about using AI-enabled tools to transform how work gets done
Experience managing vendor partners against clear performance and quality standards
Exceptional written and verbal communication skills
Bachelor’s degree required
Experience in payer operations, utilization management, claims, provider revenue cycle, or a similar high-volume healthcare environment is desired
Understanding of Medicare Advantage operations and CMS requirements is desired
MBA or advanced degree in health administration or finance is a plus

Benefits

Comp & perks

Employer sponsored health, dental and vision plan with low or no premium
Generous paid time off
$100 monthly mobile or internet stipend
Stock options for all employees
Parental leave program
401K program
Bonus eligibility for all roles excluding Director and above
Commission eligibility for Sales roles