Project Manager, Utilization Review

🔥 2 minutes ago

🏖️ New Jersey – Remote

🏖️ New Jersey – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

👷‍♀️ Project Manager

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Med-Metrix

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2010

🏥 Healthcare

☁️ SaaS

🔥 Funding within the last year

💰 Private equity on 2025-09

Healthcare • SaaS

Med-Metrix is a company for which only a minimal web presence was provided (the page only displayed "Loading application... Your web browser must have JavaScript enabled... "). No product, market, or mission details were included in the supplied text. Based on the company name alone, it plausibly focuses on medical or clinical metrics, analytics, or healthcare software, but that is speculative and not confirmed by the provided information. Further public details would be required to be more specific.

📋 Description

• Provide operational and analytical support to Physician Advisory end-to-end clients • Prepare and participate in client review meetings, including decks, data summaries, and presentations • Track deliverables, timelines, and client escalations • Support client onboarding processes and operational handoffs • Analyze utilization data, case trends, and client performance metrics • Investigate clinical and operational issues for end-to-end clients • Prepare data-driven summaries and recommendations for leadership review • Participate in evaluation of hospital utilization review processes and application of screening tools • Support reporting infrastructure and PowerBI data validation • Lead ad-hoc projects for end-to-end clients • Provide support on time-sensitive deliverables and client requests • Manage project timelines, resources, and stakeholder coordination • Serve as operational point of contact for end-to-end clients • Support escalation resolution and issue tracking • Contribute to operational efficiency improvements • Use, protect, and disclose patients’ protected health information only in accordance with HIPAA standards • Comply with Information Security and HIPAA policies and procedures • Limit viewing of protected health information to the minimum necessary

🎯 Requirements

• Active RN license required • Utilization Review experience required • 4+ years of healthcare compliance and utilization review experience required • 3+ years of project management experience required • PM certification is a plus • Proficiency with data analysis tools required • MCG and IQ application expertise required • End-to-end client or managed care operations experience • PowerBI or data visualization experience preferred • Proficiency in Microsoft Office Suite • Strong interpersonal and communication skills • Strong problem-solving and creative skills • Ability to exercise sound judgment and make decisions based on accurate and timely analyses • High level of integrity and dependability • Strong sense of urgency and results orientation • Excellent written and verbal communication skills required • Must possess a smartphone or electronic device capable of downloading applications for multifactor authentication and security purposes • Ability to follow directions, collaborate with others, and handle stress • Ability to perform the stated physical and computer-related duties