Job Description

This position is posted by Jobgether on behalf of a partner company. We are currently looking for a Policy Governance Professional. In this role, you will play a crucial part in the development and management of Utilization Management (UM) policies and procedures, working closely with governance committees to ensure compliance with regulatory standards. Your responsibilities will involve the preparation of clear documentation and reports that support organizational objectives and continuous improvement initiatives. With a focus on quality metrics, your insights will directly inform decision-making processes and enhance the overall consumer experience.

Accountabilities

• Assist with the development, review, and maintenance of UM policy and procedure documentation, ensuring compliance with regulatory requirements and enterprise standards.
• Support UM governance activities and provide committee support by preparing meeting materials, documenting meeting minutes, and tracking action items.
• Collect, analyze, and report on UM quality metrics to inform decision-making and support continuous improvement efforts.
• Prepare clear, concise, and accurate written communications, summaries, and reports related to UM governance, quality metrics, and policy activities.
• Facilitate communication and training related to UM policy requirements, reporting resources, and compliance protocols.
• Assist with the escalation and documentation of suspected policy violations in accordance with established procedures.

Requirements

• Bachelor's degree.
• Less than 5 years of technical experience.
• Experience with UM operations, policy governance, committee support, and/or quality reporting in a healthcare environment.
• Strong written communication and documentation skills.
• Familiarity with regulatory standards (e.g., HIPAA, HITRUST, NIST) and compliance practices.
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences.

Benefits

• Health benefits effective day 1.
• Paid time off, holidays, volunteer time and jury duty pay.
• Recognition pay.
• 401(k) retirement savings plan with employer match.
• Tuition assistance.
• Scholarships for eligible dependents.
• Parental and caregiver leave.
• Employee charity matching program.
• Network Resource Groups (NRGs).
• Career development opportunities.

Why Apply Through Jobgether?

We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team.

We appreciate your interest and wish you the best!

Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time.

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We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.

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