Clinical Operations Program Manager--UM Operations

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Clinical Operations Program Manager--UM Operations based in United States.

This role leads operational programs and initiatives supporting Utilization Management (UM) and Clinical Appeals within a complex healthcare environment. You will coordinate market readiness, workflow improvements, compliance activities, audit preparation, reporting accuracy, and cross-functional deliverables. The position combines program management with operational analysis, stakeholder coordination, and continuous process improvement. You will work closely with clinical, operational, training, auditing, compliance, technology, and business teams to drive effective implementation and issue resolution. The role also provides visibility with senior leaders and executive stakeholders through program reporting, metrics, and decision support. It is an opportunity to make a meaningful impact on healthcare operations while strengthening regulatory readiness and member-focused processes.