Director – WTS

🕒 6 dias atrás

🤠 Texas – Remoto

🤠 Texas – Remote

💵 $150.000 - $160.000 / ano

⏰ Tempo Integral

🔴 Especialista

👔 Diretor

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WNS

SiteLinkedInTodas as Vagas

10.000+ funcionários

Fundada em 1996

⚖️ Jurídico

📦 Logística

📣 Marketing

Legal • Logistics • Marketing

WNS é uma empresa global de Business Process Management (BPM) que atua em 13 países, com mais de 66 centros de entrega, e emprega mais de 62 mil pessoas. A organização tem compromisso com a inclusão e a diversidade, promovendo uma cultura única de cocriação e aprendizado contínuo. A WNS oferece diversas oportunidades de carreira na Ásia-Pacífico, Europa, África e Américas e se orgulha de um processo de recrutamento transparente e baseado em mérito. Como líder em seu segmento, a WNS foca no desenvolvimento de futuros líderes e tomadores de decisão, mantendo forte ênfase em responsabilidade social por meio de iniciativas como a WNS Cares Foundation.

Descrição

• 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

🎯 Requisitos

• 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

🏖️ Benefícios

• 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

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