Product Manager - Utilization Management

Product Manager

• Utilization Management at Highmark Health

Are you passionate about shaping the future of healthcare products? We’re looking for a Product Manager to join our Utilization Management team. In this role, you’ll be the driving force behind the fundamental value proposition of our products, outlining a clear vision and execution plan while rallying key strategic partners and stakeholders.

You’ll also oversee the execution of that vision, attending sprint and milestone reviews with our Delivery team to ensure everything stays on track.

This position is perfect for someone who thrives on understanding both the department’s and the company’s strategic roadmap. If you’re located within a 50-mile radius of a Highmark office in PA, DE, WV, or NY, this is a hybrid role requiring three days in the office. For those outside that radius, remote work is a possibility.

What You’ll Do

You’ll develop a holistic product vision and corresponding strategy to drive maximum value, always staying ahead of the game by anticipating future needs and using metrics and qualitative input to identify improvement opportunities.

You’ll represent the product in all governance meetings, clearly communicating roadmaps, priorities, experiments, and decisions to audiences ranging from the product team all the way up to executive levels. Additionally, you’ll serve as the accountable owner for a set of products or tools within the designated portfolio, identifying and driving cross-product and cross-customer value and shared learnings.

Ownership of the product backlog is a core responsibility—you’ll use input from internal and partner teams to frequently refresh and re-prioritize the backlog.

What You Bring

To succeed in this role, you’ll need at least three years of product experience, including three years working with the software lifecycle and one year of advanced domain experience. A Bachelor’s Degree in science, technology, mathematics, or a related field is required, though relevant experience and/or education may be considered in lieu of the degree.

Core Skills and Experience

• Stakeholder Management: Proven ability to build and maintain strong relationships with internal and external stakeholders, including clinical leaders, IT teams, and vendors.
• **Analytical & Problem
• Solving Acumen:** Demonstrated ability to analyze complex data, identify trends, and develop innovative solutions to improve product performance. You’re also skilled at identifying, analyzing, and resolving complex issues related to product development and implementation.
• Data Interpretation & Visualization: You can translate data insights into compelling visuals and reports for executive-level consumption.
• Presentation Skills: Exceptional ability to present complex information clearly to diverse audiences, including executives, clinicians, and technical teams. You’re also comfortable delivering engaging product demonstrations and walkthroughs.
• Utilization Management & Clinical Expertise: A strong understanding of utilization management principles, processes, and industry best practices. Familiarity with medical terminology, healthcare delivery systems, and clinical guidelines relevant to utilization management is essential. Previous experience in the healthcare industry, with a focus on utilization management or related areas, is highly preferred.

Preferred Experience

• One year of experience with the Agile process.
• Background in the healthcare industry, particularly in utilization management or related fields.

Work Arrangement and Benefits

This position offers a base pay range of $86,400 to $138,600 annually, with compensation determined by factors such as your qualifications, experience, expected contributions, internal peer equity, market conditions, and business considerations. Highmark Health may also apply a geographic differential for certain locations based on comparative markets.

Travel requirements are minimal—typically 0% to 25% of the time. The role is office-based, with regular teaching and training of others. You’ll occasionally travel from the office to various work sites or from site to site. Lifting up to 10 pounds is constant, with 10 to 25 pounds rarely required.

About Highmark Health

Highmark Health is a national, blended health organization that includes one of America’s largest Blue Cross Blue Shield insurers and a growing regional hospital and physician network.

Based in Pittsburgh, Pa., our 35,000 employees serve millions of customers nationwide through our affiliated businesses, which include Highmark Inc., Allegheny Health Network, HM Insurance Group, United Concordia Dental, HM Health Solutions, and HM Home & Community Services.

We’re proud to offer a broad spectrum of health-related services, from health insurance and healthcare delivery to population health management, dental solutions, reinsurance solutions, and innovative technology solutions.