Product Manager - Utilization Management

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Product Manager - Utilization Management

Work At Home - Pennsylvania, Home PA 90001, United States

Full time

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Job DescriptionWorking with UsBenefits & PerksHear From Our TeamHow We Hire

Job Details

Category Product & Experience

Type Full time

Location(s) Work At Home - Pennsylvania, Home PA 90001, United States

Brand Highmark Health

Posted 11/10/2026

Req ID J284580

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Job Description

Company :

Highmark Health

Job Description :

JOB SUMMARY

• If located within a 50 mile radius of a Highmark office in PA, DE, WV or NY this is a hybrid role requiring 3 days in office
• Note additional detail in Preferred Experience section

This job defines the product's fundamental value proposition, outlines vision and execution plan, gains alignment and support from key strategic partners and stakeholders, and oversees execution of that vision. This incumbent will attend sprint/milestone reviews with the Delivery team.

ESSENTIAL RESPONSIBILITIES

• Understand the department"s and the company"s strategic roadmap and competitive position, and develops a holistic product vision and the corresponding product strategy to drive maximum value. Clearly set and communicate roadmaps, priorities, experiments, and decisions across audiences, from product team to executive levels.

• Actively anticipates future needs and utilizes metrics and qualitative input to identify asset improvement opportunities.

• Represent the product in all governance meetings.

• Clearly sets and communicates roadmaps, priorities, experiments, and decisions across audiences, from product team to executive levels.

• Serve as accountable owner for the sets of products/tools within the designated portfolio.

• Identify and drives both cross-product and cross-customer value and shared learnings.

• Own the product backlog and uses input from internal and partner teams to frequently refresh and re-prioritize the backlog.

• Other duties as assigned.

EDUCATION

Required

• Bachelor"s Degree in science, technology, mathematics or related field OR relevant experience and/or education as determined by the company in lieu of bachelor's degree

Preferred

• None

EXPERIENCE

Required

• 3 years of Product experience

To Include:

• 3 years with the Software Lifecycle

• 1 year of Advanced domain experience

Preferred

• 1 year with the Agile process

• Relationship & Stakeholder Management:

• Stakeholder Management: Experience in building and maintaining strong relationships with internal and external stakeholders, including clinical leaders, IT teams, and vendors.

• Analytical & Problem-Solving Acumen:

• Analytical and Critical Thinking: Demonstrated ability to analyze complex data, identify trends, and develop innovative solutions to improve product performance.

• Problem-Solving: Ability to identify, analyze, and resolve complex issues related to product development and implementation.

• Data Interpretation & Visualization: Ability to translate data insights into compelling visuals and reports for executive-level consumption.

• Presentation Skills: Exceptional presentation and communication skills, with the ability to effectively present complex information to diverse audiences, including executives, clinicians, and technical teams.

• Demonstration Skills: Proven ability to deliver engaging and informative product demonstrations and walkthroughs.

• Utilization Management & Clinical Expertise:

• Utilization Management Knowledge: A strong understanding of utilization management principles, processes, and industry best practices.

• Clinical Knowledge: Familiarity with medical terminology, healthcare delivery systems, and clinical guidelines relevant to utilization management.

• Healthcare Industry Experience: Previous experience working in the healthcare industry, with a focus on utilization management or related areas

• Communication & Presentation Proficiency:

• Presentation Skills: Exceptional presentation and communication skills, with the ability to effectively present complex information to diverse audiences, including executives, clinicians, and technical teams.

• Demonstration Skills: Proven ability to deliver engaging and informative product demonstrations and walkthroughs.

• Utilization Management & Clinical Expertise:

• Utilization Management Knowledge: A strong understanding of utilization management principles, processes, and industry best practices.

• Clinical Knowledge: Familiarity with medical terminology, healthcare delivery systems, and clinical guidelines relevant to utilization management.

• Healthcare Industry Experience: Previous experience working in the healthcare industry, with a focus on utilization management or related areas.

LICENSES or CERTIFICATIONS

Required

• None

Preferred

• None

SKILLS

• Business Acumen for P&Ls

• Communication

• Conflict Management

Language (Other than English):

None

Travel Requirement:

0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Office-based

Teaches / trains others regularly

Frequently

Travel regularly from the office to various work sites or from site-to-site

Occasionally

Works primarily out-of-the office selling products/services (sales employees)

Never

Physical work site required

Yes

Lifting: up to 10 pounds

Constantly

Lifting: 10 to 25 pounds

Rarely

Lifting: 25 to 50 pounds

Never

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy.

Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Pay Range Minimum:

$86,400.00

Pay Range Maximum:

$138,600.00

Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.

California Consumer Privacy Act Employees, Contractors, and Applicants Notice

Why Choose Highmark Health?

At Highmark Health, we are on a mission to reinvent healthcare for everyone. When you bring your curiosity and drive to our award-winning team, you will find continuous opportunities to grow your career, break down barriers in the industry, and make a meaningful impact every day.

Benefits & Perks

Taking Care of You

Your Benefits at a Glance

• Health: Complete medical, dental, vision, prescription, HSA, and FSA coverage.
• Time Off: Paid vacation, holidays, and dedicated volunteer time.
• Finance: Employer-sponsored 401(k), life/disability insurance, and tuition reimbursement.
• Perks: Exclusive team discounts on shopping, memberships, and events.

Medical Coverage

Medical, prescription drug, dental, and vision coverage

Paid Time Off

Vacation, holidays, volunteering

Retirement Package

Employer-sponsored 401(k) plan

Insurance & Coverage

Life, AD&D and disability insurance

Onsite & Preventative Care

We make staying healthy easy with 100% covered preventative exams (including flu shots) and onsite pharmacy services at major campuses. Plus, stay active with free fitness center access at major Highmark campuses, Allegheny General, and West Penn Hospital.

Make Mindful Changes

Secure bicycle parking at major campuses. Healthy food options at onsite cafeterias. Stress management classes including yoga, mindfulness, and meditation.

Holistic Support, 24/7

Work-life resources including assistance programs and financial counseling services. 24/7 telephone access to health and wellness coaching.

Get Rewarded for Giving Back

Health incentive program that rewards team members. Team member networks to gather in the name of health. Paid volunteer time and incentives for making a difference.

Hear from Our Team

Real people, real stories

"I have met some really great people over the years at Highmark Health and the company has treated me really well. I get really good benefits. I"ve always been rewarded for working hard. That"s what keeps me here."

Victoria T.

Associate Strategy Analyst, enGen

"I love participating with the PRIDE BRG. It"s an engaged, dynamic group of almost 400 people. I also love to turn on the digital hub on my computer and see what"s going on with any of the Business Resource Groups. It"s really neat to be able to support other BRGs and see others support PRIDE. Every time I go to a different BRG event, I always feel welcome, even if I"m not part of that group."

Amanda M.

Director of Social Determinants of Health | Vice Chair of PRIDE

Our Hiring Process: Step-by-Step

1. Apply

Find a role that sparks your passion and submit your application! We'll send an immediate confirmation email, and our team will review your qualifications over the next 1-2 weeks.

2. Interview

If your profile is a great match, we'll reach out to schedule your interview-whether by phone, video, or in person. Don"t worry, we'll provide all the prep details in advance so you can shine.

3. Job Offer

The moment you've been waiting for! If selected, we'll connect to celebrate and walk you through the details: compensation, benefits, paid time off, and all the perks of joining the team.

4. Pre-Employment

After you accept online, we'll guide you through standard screening (including a background check and drug screen, plus health screenings for certain clinical roles). Once cleared, we"ll officially confirm your start date!

5. Onboarding

Welcome aboard! Before Day 1, we'll send everything you need to hit the ground running-including your schedule, location, and the required identification documents to bring with you.

Bonus Fast-Track Tip

Applying for EVS, Dietary, or Customer Service roles? You can skip the traditional line and chat with Bridget, our AI recruiting assistant, to find open roles and schedule an eligible interview instantly.

Apply Now

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Highmark Health is an independent licensee of the Blue Cross Blue Shield Association.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.

We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org

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