Director – WTS

WNS

. Partner with leadership to define and execute the product strategy for Utilization Management solutions .

Posted 11/6/2026full-timeRemote • Texas • United StatesLead💰 $150,000 - $160,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in product management and utilization management, with a strong focus on developing business cases, managing cross-functional initiatives, and optimizing healthcare operations. Proficient in analyzing performance metrics and implementing solutions to enhance user experience and compliance.

Highest-signal resume keywords

Product ManagementUtilization Management ProcessesBusiness Case DevelopmentCross-Functional Initiative ManagementRegulatory Framework Familiarity

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Utilization ManagementBusiness Case DevelopmentProduct Feature DefinitionData AnalysisKPI TrackingCost-Benefit AnalysisAgile MethodologyHealthcare OperationsAutomation ImprovementUser Experience Optimization

Soft Skills

Analytical SkillsProblem-Solving SkillsCollaborationChange ManagementCommunication

Tools & Technologies

UM PlatformsCare Management SystemsHealth IT Solutions

Industry Keywords

CMSNCQAURACHealthcare AdministrationClinical Background

About the role

Key responsibilities & impact

Partner with leadership to define and execute the product strategy for Utilization Management solutions
Lead product and feature definition, translating business, clinical, and regulatory needs into product concepts and requirements
Develop and maintain product roadmaps for new capabilities and legacy system enhancements
Identify opportunities to improve utilization review processes, cost management, compliance, and user experience
Develop business cases for new products and major enhancements, including ROI, cost-benefit analysis, and operational impact
Quantify expected improvements in utilization efficiency, turnaround times, cost savings, and quality outcomes
Present recommendations and investment justifications to senior leadership
Partner with finance, operations, and clinical teams to validate assumptions and track realized value
Drive product initiatives from concept through delivery and post-launch optimization
Create detailed requirements for development teams
Evaluate technologies that improve HealthHelp’s competitive positioning
Prioritize backlog based on business value, regulatory requirements, and user impact
Collaborate with IT, clinical, operations, and compliance teams to ensure successful delivery
Assess UM platforms, workflows, and capabilities to identify gaps and enhancement opportunities
Lead improvements in automation, scalability, usability, and compliance
Drive continuous improvement of UM program performance through product innovation and optimization
Define, track, and report KPIs including turnaround time, denial/approval accuracy, cost containment, and user adoption
Use data insights and stakeholder feedback to identify performance gaps and implement targeted solutions
Liaise across product, clinical, operations, IT, compliance, and executive stakeholders
Facilitate alignment on priorities, timelines, and success metrics
Support change management, training, and adoption of new features and enhancements

Requirements

What you’ll need

Bachelor’s degree in Healthcare Administration, Business, Technology, or related field
5–8+ years of experience in product management, utilization management, or healthcare operations
Strong knowledge of UM processes (prior authorization, concurrent review, medical necessity review)
Experience developing business cases and leading product/feature definition
Proven ability to manage complex, cross-functional initiatives
Strong analytical and problem-solving skills
Experience with UM platforms, care management systems, or health IT solutions preferred
Familiarity with CMS, NCQA, URAC, and other regulatory frameworks preferred
Experience in Agile or hybrid product environments preferred
Clinical background (e.g., RN, LPN) or equivalent experience preferred

Benefits

Comp & perks

Medical, dental, and vision insurance
Paid time off (PTO), holidays, and sick leave
401(k) with company match or other retirement plan
Life and AD&D Insurance
Employee Assistance Program
Performance-based bonuses, incentive pay, or commissions may be available