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Senior Project Manager – Utilization Management

Remote, USA Full-time Posted 2025-11-03
Description: • Managing critical projects assigned to the UM COE that solve business challenges and support the development of new sources of value within Aetna’s Clinical Solutions business unit • Evaluating, designing, and implementing new regulatory and/or business initiatives for Utilization Management from initiation through completion • Partnering cross-functionally to identify business needs and develop solutions and tactics to drive process improvement • Securing required resources and using formal processes and tools to manage those resources, budgets, risks and changes • Managing projects to ensure on-time completion according to specifications and within budgeted costs • Tracking progress against key milestones and creating and implementing value-based metrics and analysis to measure outcomes • Contributing to a motivated work environment by working collaboratively and effectively with key stakeholders across Health Care Business and Aetna Clinical Solutions to achieve common goals • Fostering a culture that accelerates our strategy through our Heart At Work Behaviors by keeping the customer and colleague as the central focus Requirements: • 7+ years of experience in healthcare in a role that involves strategic problem solving and/or new product development (e.g. consulting) • 7+ years of demonstrated organizational skills (e.g. project management experience or managing cross-team/department initiatives with demonstrated success) • Strong interpersonal and communication skills, effectively communicate key messages to executive leaders and internal/external stakeholders • Strong verbal and written communication skills; proven ability to deliver presentations to senior leadership team members • Strong data and analytics skills to include modeling, synthesizing information and deriving key insights • Strong understanding within clinical and health plan operations and value creation methodologies including Utilization and Policy Management, Care Management and Coordination, Quality, Compliance and Regulatory Management • Successful experience in strategy, innovation and/or portfolio management within healthcare industry • High ability to consistently produce and create value and meet/exceed committed performance • Effectively lead and motivate teams to ensure high standards of performance and outcomes Benefits: • Affordable medical plan options • 401(k) plan (including matching company contributions) • Employee stock purchase plan • No-cost programs including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching • Paid time off • Flexible work schedules • Family leave • Dependent care resources • Colleague assistance programs • Tuition assistance • Retiree medical access Apply tot his job Apply To this Job

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