Tech Summary: The Product Manager IV, Health Systems supports the Care Delivery & Digital Engineering (CDDE) organization by leading the implementation, optimization, and support of enterprise clinical applications that enhance care delivery, utilization management, and operational effectiveness. This role partners with clinical, operational, and technical stakeholders to deliver scalable technology solutions that improve user experience and support organizational objectives. Working across complex healthcare technology environments, this position supports initiatives related to Utilization Management, care coordination, referral management, and clinical operations, including Epic-based solutions such as Tapestry UM, Payer Platform, Care Everywhere Referral Management (CERM), and Clinical Case Management (CCM). The role serves as a bridge between business and technology teams, helping translate operational needs into effective solutions while communicating with technical, operational, and executive stakeholders to drive successful outcomes Job Summary: This senior individual contributor role is primarily responsible for defining product strategy and vision, developing product roadmaps from ideation to launch, and making decisions on new products or enhancements to bring to market. This includes developing product enhancements based on validated learnings, serving as a facilitator for product teams and diverse stakeholder groups across the organization, and collaborating with operations teams and market stakeholders to support product adoption. This role is also responsible for performing internal and external discovery for new and existing products, validating solutions with end users, funneling learnings to product roadmaps, tracking outcomes and key performance indicators, and partnering with product team members to solve user problems. Essential Responsibilities: Completes work assignments and supports business-specific projects by applying expertise in subject area; supporting the development of work plans to meet business priorities and deadlines; ensuring team follows all procedures and policies; coordinating and assigning resources to accomplish priorities and deadlines; collaborating cross-functionally to make effective business decisions; solving complex problems; escalating high priority issues or risks, as appropriate; recognizing and capitalizing on improvement opportunities. Practices self-development and promotes learning in others by proactively providing information, resources, advice, and expertise with coworkers and customers; building relationships with cross-functional stakeholders; influencing others through technical explanations and examples; adapting to competing demands and new responsibilities; listening and responding to, seeking, and addressing performance feedback; providing feedback to others and managers; creating and executing plans to capitalize on strengths and develop weaknesses; supporting team collaboration; adapting to and learning from change, difficulties, and feedback. Defines product strategy and vision, and develops product roadmaps from ideation to launch by making decisions on new products or enhancements to bring to market; evaluating potential business process changes, system impacts, and flow concepts to determine the viability of implementing desired enhancements; providing an end-to-end holistic view of how specific business processes and internal system configurations impact the user experience; developing business cases for new products, improvements to existing products, and/or business ventures; defining, managing, and avoiding technical debt as appropriate; developing product enhancements based on validated learnings; ensuring documentation clearly communicates customer/stakeholder needs to the product team; and working with team members to clarify features and requirements as necessary. Serves as a facilitator for the product team and diverse stakeholder groups across the organization throughout the product management life cycle by coordinating the resolution of inter-squad, cross-product and external dependencies, roadblocks and constraints; collaborating with operations teams and market stakeholders to support product adoption; coordinating training efforts to build readiness for production support and operational readiness teams; leading feature demos for stakeholders; providing product expertise, peer training, and consultation as appropriate; and adhering to enterprise compliance standards and managing technology risks appropriately. Performs internal and external discovery for new and existing products by collaborating with business partners to identify needs; identifying marketplace innovation; prototyping and validating with end users with support from UX design and research, engineering, and other stakeholders as appropriate; and funneling learnings to the product roadmap. Tracks outcomes and key performance indicators by defining and tracking KPIs and performance metrics (e.g., speed, quality, etc.); reviewing analytical dashboards and assessing KPI alignment; and developing and/or maintaining ad hoc reports, status updates, and presentation decks for key stakeholders. Partners with product team members to solve user problems by prioritizing the work backlog to ensure balance across new development, non-functional requirements, and technical work (e.g., maintenance, support, technical debt, etc.); and collaborating on competitive and user research/testing, experimentation, and/or design thinking initiatives. Minimum Qualifications: Bachelors degree in Computer Science, Business Administration, Information Systems Management, Data Analytics, Engineering, Social Science, or related field and minimum five (5) years experience in product management, project management, IT consulting, product development or support, business/system analysis, or a directly related field. Additional equivalent work experience in a directly related field may be substituted for the degree requirement. Advanced degrees may be substituted for a portion of the work experience requirements. Minimum two (2) years experience working with agile teams, including familiarity with scrum ceremonies and agile best practices. Minimum one (1) year experience in a leadership role with or without direct reports.
08/25/2026
Full time
Tech Summary: The Product Manager IV, Health Systems supports the Care Delivery & Digital Engineering (CDDE) organization by leading the implementation, optimization, and support of enterprise clinical applications that enhance care delivery, utilization management, and operational effectiveness. This role partners with clinical, operational, and technical stakeholders to deliver scalable technology solutions that improve user experience and support organizational objectives. Working across complex healthcare technology environments, this position supports initiatives related to Utilization Management, care coordination, referral management, and clinical operations, including Epic-based solutions such as Tapestry UM, Payer Platform, Care Everywhere Referral Management (CERM), and Clinical Case Management (CCM). The role serves as a bridge between business and technology teams, helping translate operational needs into effective solutions while communicating with technical, operational, and executive stakeholders to drive successful outcomes Job Summary: This senior individual contributor role is primarily responsible for defining product strategy and vision, developing product roadmaps from ideation to launch, and making decisions on new products or enhancements to bring to market. This includes developing product enhancements based on validated learnings, serving as a facilitator for product teams and diverse stakeholder groups across the organization, and collaborating with operations teams and market stakeholders to support product adoption. This role is also responsible for performing internal and external discovery for new and existing products, validating solutions with end users, funneling learnings to product roadmaps, tracking outcomes and key performance indicators, and partnering with product team members to solve user problems. Essential Responsibilities: Completes work assignments and supports business-specific projects by applying expertise in subject area; supporting the development of work plans to meet business priorities and deadlines; ensuring team follows all procedures and policies; coordinating and assigning resources to accomplish priorities and deadlines; collaborating cross-functionally to make effective business decisions; solving complex problems; escalating high priority issues or risks, as appropriate; recognizing and capitalizing on improvement opportunities. Practices self-development and promotes learning in others by proactively providing information, resources, advice, and expertise with coworkers and customers; building relationships with cross-functional stakeholders; influencing others through technical explanations and examples; adapting to competing demands and new responsibilities; listening and responding to, seeking, and addressing performance feedback; providing feedback to others and managers; creating and executing plans to capitalize on strengths and develop weaknesses; supporting team collaboration; adapting to and learning from change, difficulties, and feedback. Defines product strategy and vision, and develops product roadmaps from ideation to launch by making decisions on new products or enhancements to bring to market; evaluating potential business process changes, system impacts, and flow concepts to determine the viability of implementing desired enhancements; providing an end-to-end holistic view of how specific business processes and internal system configurations impact the user experience; developing business cases for new products, improvements to existing products, and/or business ventures; defining, managing, and avoiding technical debt as appropriate; developing product enhancements based on validated learnings; ensuring documentation clearly communicates customer/stakeholder needs to the product team; and working with team members to clarify features and requirements as necessary. Serves as a facilitator for the product team and diverse stakeholder groups across the organization throughout the product management life cycle by coordinating the resolution of inter-squad, cross-product and external dependencies, roadblocks and constraints; collaborating with operations teams and market stakeholders to support product adoption; coordinating training efforts to build readiness for production support and operational readiness teams; leading feature demos for stakeholders; providing product expertise, peer training, and consultation as appropriate; and adhering to enterprise compliance standards and managing technology risks appropriately. Performs internal and external discovery for new and existing products by collaborating with business partners to identify needs; identifying marketplace innovation; prototyping and validating with end users with support from UX design and research, engineering, and other stakeholders as appropriate; and funneling learnings to the product roadmap. Tracks outcomes and key performance indicators by defining and tracking KPIs and performance metrics (e.g., speed, quality, etc.); reviewing analytical dashboards and assessing KPI alignment; and developing and/or maintaining ad hoc reports, status updates, and presentation decks for key stakeholders. Partners with product team members to solve user problems by prioritizing the work backlog to ensure balance across new development, non-functional requirements, and technical work (e.g., maintenance, support, technical debt, etc.); and collaborating on competitive and user research/testing, experimentation, and/or design thinking initiatives. Minimum Qualifications: Bachelors degree in Computer Science, Business Administration, Information Systems Management, Data Analytics, Engineering, Social Science, or related field and minimum five (5) years experience in product management, project management, IT consulting, product development or support, business/system analysis, or a directly related field. Additional equivalent work experience in a directly related field may be substituted for the degree requirement. Advanced degrees may be substituted for a portion of the work experience requirements. Minimum two (2) years experience working with agile teams, including familiarity with scrum ceremonies and agile best practices. Minimum one (1) year experience in a leadership role with or without direct reports.
Director of Student Care Amherst Campus Full Time JR7131 Amherst has taken a leadership role among highly selective liberal arts colleges and universities in successfully diversifying the racial, socio-economic, and geographic profile of its student body. The College is similarly committed to enriching its educational experience and its culture through the diversity of its faculty, administration and staff. Job Description: Amherst College invites applications for the Director of Student Care position. The Director of Student Care is a full-time, year-round position. The expected salary range for this job opportunity is: $90,000 to $100,000. Reporting to the Associate Dean of Students and Class Dean (the Associate Dean) and as a member of the Office of Student Affairs (OSA), the Director of Student Care (the Director) is responsible for supporting a vibrant community of students at Amherst College by overseeing and creating policies, processes, and practices that are transparent and equitable, and ensure that students of concern are connected to appropriate levels of care. The Care & Accountability Team's focus is on the creation of communities that emphasize comprehensive student development in an environment that is challenging and supportive. The Student Care team serves as the hub of support for students who are experiencing difficulties related to mental health, physical health, psycho-social adjustment, financial, familial, and/or personal challenges by providing direct case management services, including interventions, referrals, and follow-up services. The Director is principally responsible for overseeing the Care Team's collaborative approach to student support. The Director maintains a caseload of students and plays a significant role in triaging concerns and consulting with campus partners such as Class Deans, health care providers, Student Affairs colleagues, faculty members, staff, students, and families. The Director partners with the Associate Dean on the coordination of the multi-department workflow of the Leave/Return process. The Director spearheads campus outreach and professional and student staff training on student support processes. The Director serves in the second tier of after hours on-call rotation. Due to the nature of this position, early mornings, evenings, and weekends may be required. Summary of Responsibilities: Department Leadership Provides strategic direction, operational oversight, and guidance for the Student Care team. Oversees the development, supervision, and assessment of policies, practices, services, systems, and processes that facilitate support for students who are experiencing difficulties related to mental health, physical health, psycho-social adjustment, financial, familial, and/or personal challenges in collaboration with the other Student Affairs departments and campus partners. Hires, on-boards, supervises, and evaluates the Student Care Coordinator. Oversees work of wellbeing checks and outreach of the Area Coordinators. Student Support Manages a caseload of students experiencing significant difficulties related to mental health, physical health, psycho-social adjustment, financial, familial, and/or personal challenges. Collaborates with the Associate Dean to develop and maintain partnerships and protocols with community resources and campus partners, including the Center for Counseling and Mental Health (CCMH), the Health Center, Accessibility Services, Athletics, and Campus Police. Serves as a primary liaison for student support during hospitalizations, including liaising with emergency and family contacts, peer groups, on- and off-campus treatment providers, Class Deans, other Office of Student Affairs staff, coaches, and/or employers, and other involved parties. Engages with students, support networks, and providers throughout the hospital discharge planning and medical clearance process, including delivering follow-up support and assisting students with tracking multiple resources upon discharge. Assists with withdrawal and departure from campus when medical clearance cannot be established. Communicates with staff and other concerned individuals, such as family members or peers, when there are crises or critical incidents that impact a student or multiple students/people in the community, and with families, deans, faculty, and other necessary partners to assist with coordinated care plans and management of high-risk students. Collaborate with the Associate Dean and/or General Counsel to develop behavioral expectations statements in cases of high-risk student behaviors. Maintains thorough knowledge of College standards and practices, including the Student Code of Conduct, and related state and federal laws such as FERPA, HIPAA, Title IX, Section 504, and the Americans with Disabilities Act. Workflow and Recordkeeping Facilitates the cross-departmental Care Team Meeting. Prepares agenda, leads meetings, and arranges for appropriate follow-up in collaboration with all Care Team Meeting members. Oversee the triage of Care Reports, reports from campus police, Office of Community Living, administrators-on-call, faculty, staff, parents, and others. Assigns and routes student concerns to appropriate staff/faculty support resources by entering case data into Maxient workflow, in accordance with Student Affairs protocol. Partners with Associate Dean on Leave/Return Process. Serves on the Leave/Return Committee. Follows up with reporting parties to collect pertinent case details and to provide updates on case progress, with respect to student privacy. Ensures assigned cases are receiving timely attention and that records are being kept in accordance with College protocol. Assists in preparation of annual report and other reports and analyses as requested. Collects data, prepares and distributes statistical reports regarding key student support initiatives; analyzes trends. Team Support, Training, and Outreach Facilitates weekly Case Review meetings in collaboration with the Associate Dean and Director of Community Standards. Regularly reviews specific student support cases with the Care & Accountability Team and other members of OSA. Prepares agenda, leads meetings, and arranges for appropriate follow-up. Communicates student care and support services initiatives to the College community through outreach education, training, consultation, and the production and distribution of materials to faculty, staff, and students. Serves as a resource, trainer and consultant to faculty, staff, and students on recognizing and responding to students at risk and reporting concerns. Serves as a resource to Health/Counseling Centers to assist students with referrals and connections to off-campus resources. Offers regular consultation to Office of Student Affairs staff, including the Class Deans, Accessibility, and others. Reviews active student support cases, offers guidance on documentation and communication strategies, and plans strategic goals. Provides training and mentorship on navigating college and community resources. Student Affairs Generalist Serves as a member of the Behavioral Intervention Team. Serves on a rotational basis as a Tier 2 Administrator on-Call for Student Affairs during the day/nights/weekends. Responds to crisis situations, assesses and refers at-risk students for additional intervention by appropriate personnel. Submits an annual report outlining goals, progress, assessment, and emerging opportunities. Participates in a wide range of discussions regarding strategic planning for the Care & Accountability Team and the Office of Student Affairs. Serves on campus-wide committees as appropriate. Qualifications: Required Master's degree in Education, Counseling, Social Work, or a closely related field. 5 to 7 years of related experience. Five years of pertinent experience in case management, student support, crisis intervention in higher education, including progressively greater levels of responsibility and accountability. Experience leading and supervising professional staff and demonstrated commitment to the professional development of those members. Knowledge of college student development theory and practice. Demonstrated commitment to student on-campus living and learning community development and programming. Robust understanding of academic priorities and ways in which on-campus living and learning communities and functions can promote student engagement, advance student learning, and contribute to achieving desired learning goals. Demonstrated effective administrative, supervisory, organizational, and interpersonal skills. Strong skills in written, verbal, and electronic communication Evidence-based commitment to supporting a diverse student community. Ability to work both independently and collaboratively with other Student Affairs departments and members of the faculty in the College community. Ability to exercise sound judgment, exhibit resilience under pressure, set priorities, and achieve goals. Demonstrated ability to steward sensitive and private student data toward its inclusion in operational processes and procedures. Demonstrated ability to problem-solve complex issues while functioning as an independent decision-maker Knowledge of applicable state and federal laws, including FERPA, HIPAA, Title IX, Section 504 . click apply for full job details
08/25/2026
Full time
Director of Student Care Amherst Campus Full Time JR7131 Amherst has taken a leadership role among highly selective liberal arts colleges and universities in successfully diversifying the racial, socio-economic, and geographic profile of its student body. The College is similarly committed to enriching its educational experience and its culture through the diversity of its faculty, administration and staff. Job Description: Amherst College invites applications for the Director of Student Care position. The Director of Student Care is a full-time, year-round position. The expected salary range for this job opportunity is: $90,000 to $100,000. Reporting to the Associate Dean of Students and Class Dean (the Associate Dean) and as a member of the Office of Student Affairs (OSA), the Director of Student Care (the Director) is responsible for supporting a vibrant community of students at Amherst College by overseeing and creating policies, processes, and practices that are transparent and equitable, and ensure that students of concern are connected to appropriate levels of care. The Care & Accountability Team's focus is on the creation of communities that emphasize comprehensive student development in an environment that is challenging and supportive. The Student Care team serves as the hub of support for students who are experiencing difficulties related to mental health, physical health, psycho-social adjustment, financial, familial, and/or personal challenges by providing direct case management services, including interventions, referrals, and follow-up services. The Director is principally responsible for overseeing the Care Team's collaborative approach to student support. The Director maintains a caseload of students and plays a significant role in triaging concerns and consulting with campus partners such as Class Deans, health care providers, Student Affairs colleagues, faculty members, staff, students, and families. The Director partners with the Associate Dean on the coordination of the multi-department workflow of the Leave/Return process. The Director spearheads campus outreach and professional and student staff training on student support processes. The Director serves in the second tier of after hours on-call rotation. Due to the nature of this position, early mornings, evenings, and weekends may be required. Summary of Responsibilities: Department Leadership Provides strategic direction, operational oversight, and guidance for the Student Care team. Oversees the development, supervision, and assessment of policies, practices, services, systems, and processes that facilitate support for students who are experiencing difficulties related to mental health, physical health, psycho-social adjustment, financial, familial, and/or personal challenges in collaboration with the other Student Affairs departments and campus partners. Hires, on-boards, supervises, and evaluates the Student Care Coordinator. Oversees work of wellbeing checks and outreach of the Area Coordinators. Student Support Manages a caseload of students experiencing significant difficulties related to mental health, physical health, psycho-social adjustment, financial, familial, and/or personal challenges. Collaborates with the Associate Dean to develop and maintain partnerships and protocols with community resources and campus partners, including the Center for Counseling and Mental Health (CCMH), the Health Center, Accessibility Services, Athletics, and Campus Police. Serves as a primary liaison for student support during hospitalizations, including liaising with emergency and family contacts, peer groups, on- and off-campus treatment providers, Class Deans, other Office of Student Affairs staff, coaches, and/or employers, and other involved parties. Engages with students, support networks, and providers throughout the hospital discharge planning and medical clearance process, including delivering follow-up support and assisting students with tracking multiple resources upon discharge. Assists with withdrawal and departure from campus when medical clearance cannot be established. Communicates with staff and other concerned individuals, such as family members or peers, when there are crises or critical incidents that impact a student or multiple students/people in the community, and with families, deans, faculty, and other necessary partners to assist with coordinated care plans and management of high-risk students. Collaborate with the Associate Dean and/or General Counsel to develop behavioral expectations statements in cases of high-risk student behaviors. Maintains thorough knowledge of College standards and practices, including the Student Code of Conduct, and related state and federal laws such as FERPA, HIPAA, Title IX, Section 504, and the Americans with Disabilities Act. Workflow and Recordkeeping Facilitates the cross-departmental Care Team Meeting. Prepares agenda, leads meetings, and arranges for appropriate follow-up in collaboration with all Care Team Meeting members. Oversee the triage of Care Reports, reports from campus police, Office of Community Living, administrators-on-call, faculty, staff, parents, and others. Assigns and routes student concerns to appropriate staff/faculty support resources by entering case data into Maxient workflow, in accordance with Student Affairs protocol. Partners with Associate Dean on Leave/Return Process. Serves on the Leave/Return Committee. Follows up with reporting parties to collect pertinent case details and to provide updates on case progress, with respect to student privacy. Ensures assigned cases are receiving timely attention and that records are being kept in accordance with College protocol. Assists in preparation of annual report and other reports and analyses as requested. Collects data, prepares and distributes statistical reports regarding key student support initiatives; analyzes trends. Team Support, Training, and Outreach Facilitates weekly Case Review meetings in collaboration with the Associate Dean and Director of Community Standards. Regularly reviews specific student support cases with the Care & Accountability Team and other members of OSA. Prepares agenda, leads meetings, and arranges for appropriate follow-up. Communicates student care and support services initiatives to the College community through outreach education, training, consultation, and the production and distribution of materials to faculty, staff, and students. Serves as a resource, trainer and consultant to faculty, staff, and students on recognizing and responding to students at risk and reporting concerns. Serves as a resource to Health/Counseling Centers to assist students with referrals and connections to off-campus resources. Offers regular consultation to Office of Student Affairs staff, including the Class Deans, Accessibility, and others. Reviews active student support cases, offers guidance on documentation and communication strategies, and plans strategic goals. Provides training and mentorship on navigating college and community resources. Student Affairs Generalist Serves as a member of the Behavioral Intervention Team. Serves on a rotational basis as a Tier 2 Administrator on-Call for Student Affairs during the day/nights/weekends. Responds to crisis situations, assesses and refers at-risk students for additional intervention by appropriate personnel. Submits an annual report outlining goals, progress, assessment, and emerging opportunities. Participates in a wide range of discussions regarding strategic planning for the Care & Accountability Team and the Office of Student Affairs. Serves on campus-wide committees as appropriate. Qualifications: Required Master's degree in Education, Counseling, Social Work, or a closely related field. 5 to 7 years of related experience. Five years of pertinent experience in case management, student support, crisis intervention in higher education, including progressively greater levels of responsibility and accountability. Experience leading and supervising professional staff and demonstrated commitment to the professional development of those members. Knowledge of college student development theory and practice. Demonstrated commitment to student on-campus living and learning community development and programming. Robust understanding of academic priorities and ways in which on-campus living and learning communities and functions can promote student engagement, advance student learning, and contribute to achieving desired learning goals. Demonstrated effective administrative, supervisory, organizational, and interpersonal skills. Strong skills in written, verbal, and electronic communication Evidence-based commitment to supporting a diverse student community. Ability to work both independently and collaboratively with other Student Affairs departments and members of the faculty in the College community. Ability to exercise sound judgment, exhibit resilience under pressure, set priorities, and achieve goals. Demonstrated ability to steward sensitive and private student data toward its inclusion in operational processes and procedures. Demonstrated ability to problem-solve complex issues while functioning as an independent decision-maker Knowledge of applicable state and federal laws, including FERPA, HIPAA, Title IX, Section 504 . click apply for full job details
POSITION SUMMARY/RESPONSIBILITIES Provides strategic leadership for Utilization Management programs and initiatives. Responsible for accreditation readiness, regulatory compliance oversight, performance improvement planning, delegated oversight, operational governance, and implementation of organizational UM strategies. Serves as a liaison between operational leadership, Medical Directors, executive leadership, regulatory agencies, and accreditation organizations. Provides leadership, oversight, direction, and performance management for Utilization Management staff, including clinical reviewers, denial and appeals staff, and administrative personnel. Oversees utilization review operations, prior authorization activities, concurrent review, retrospective review, appeals support, and regulatory compliance activities. Ensures consistent application of medical necessity criteria, regulatory requirements, accreditation standards, and organizational policies. Leads quality improvement initiatives, audit readiness activities, inter-rater reliability processes, staff development, and operational performance monitoring. Collaborates with Medical Directors, Care Management, Provider Relations, Compliance, Quality Management, and other departments to ensure appropriate utilization of healthcare resources, timely determinations, regulatory compliance, and member-centered care. EDUCATION/EXPERIENCE Graduate of an accredited school of professional nursing required. Bachelor's degree in Nursing (BSN). A Master's degree is preferred. Minimum five (5) years of Utilization Management experience and two (2) years of management or leadership experience are required. Demonstrated knowledge of: • NCQA Utilization Management Standards • URAC Utilization Management Standards • CMS Managed Care requirements • Texas Medicaid Managed Care regulations • Medical necessity review criteria, including InterQual , MCG , and/or organization-approved clinical review criteria • Utilization Management operations, including prior authorization, concurrent review, retrospective review, appeals, and denial management • Regulatory compliance, accreditation readiness, quality improvement, and performance monitoring Experience in a managed care organization, health plan, delegated entity, Medicare, Medicaid, or other regulated healthcare environment is preferred. LICENSURE/ CERTIFICATIONS Current unrestricted Registered Nurse (RN) license issued by the Texas Board of Nursing is required . A Magnet recognized national certification is highly desirable. Certified Case Manager (CCM), Accredited Case Manager (ACM), Utilization Management Certification, or other related certification is required. If certification is not held at the time of hire, certification may be required within two (2) years of hire or transfer into the position, consistent with organizational requirements.
08/23/2026
Full time
POSITION SUMMARY/RESPONSIBILITIES Provides strategic leadership for Utilization Management programs and initiatives. Responsible for accreditation readiness, regulatory compliance oversight, performance improvement planning, delegated oversight, operational governance, and implementation of organizational UM strategies. Serves as a liaison between operational leadership, Medical Directors, executive leadership, regulatory agencies, and accreditation organizations. Provides leadership, oversight, direction, and performance management for Utilization Management staff, including clinical reviewers, denial and appeals staff, and administrative personnel. Oversees utilization review operations, prior authorization activities, concurrent review, retrospective review, appeals support, and regulatory compliance activities. Ensures consistent application of medical necessity criteria, regulatory requirements, accreditation standards, and organizational policies. Leads quality improvement initiatives, audit readiness activities, inter-rater reliability processes, staff development, and operational performance monitoring. Collaborates with Medical Directors, Care Management, Provider Relations, Compliance, Quality Management, and other departments to ensure appropriate utilization of healthcare resources, timely determinations, regulatory compliance, and member-centered care. EDUCATION/EXPERIENCE Graduate of an accredited school of professional nursing required. Bachelor's degree in Nursing (BSN). A Master's degree is preferred. Minimum five (5) years of Utilization Management experience and two (2) years of management or leadership experience are required. Demonstrated knowledge of: • NCQA Utilization Management Standards • URAC Utilization Management Standards • CMS Managed Care requirements • Texas Medicaid Managed Care regulations • Medical necessity review criteria, including InterQual , MCG , and/or organization-approved clinical review criteria • Utilization Management operations, including prior authorization, concurrent review, retrospective review, appeals, and denial management • Regulatory compliance, accreditation readiness, quality improvement, and performance monitoring Experience in a managed care organization, health plan, delegated entity, Medicare, Medicaid, or other regulated healthcare environment is preferred. LICENSURE/ CERTIFICATIONS Current unrestricted Registered Nurse (RN) license issued by the Texas Board of Nursing is required . A Magnet recognized national certification is highly desirable. Certified Case Manager (CCM), Accredited Case Manager (ACM), Utilization Management Certification, or other related certification is required. If certification is not held at the time of hire, certification may be required within two (2) years of hire or transfer into the position, consistent with organizational requirements.
Amazon Data Services, Inc.
Fredericksburg, Virginia
AWS Infrastructure Services owns the design, planning, delivery, and operation of all AWS global infrastructure. In other words, we're the people who keep the cloud running. We support all AWS data centers and all the servers, storage, networking, power, and cooling equipment that ensure our customers have continual access to the innovation they rely on. We work on the most challenging problems, with thousands of variables impacting the supply chain - and we're looking for talented people who want to help. You'll join a diverse team of software, hardware, and network engineers, supply chain specialists, security experts, operations managers, and other vital roles. You'll collaborate with people across AWS to help us deliver the highest standards for safety and security while providing seemingly infinite capacity at the lowest possible cost for our customers. And you'll experience an inclusive culture that welcomes bold ideas and empowers you to own them to completion. AWS is used by millions of users around the globe-from small start-ups to household names like Netflix and NASA-and AWS Support is one of the largest and fastest growing business units within AWS. Our team's goal is to innovate and to improve customer success, trust, and experiences with both AWS products and with AWS Support. Our team has the rare opportunity to support every service and every AWS account, and we are obsessed with creating exceptional customer experiences. Because of our team's broad mission and scope, we need a talented, passionate senior product experience designer who can create elegant, intuitive user interfaces and who has strong ideation skills, robust holistic systems thinking, deep attention to detail, and passion for turning difficult tasks into simple and delightful experiences for customers. We produce and support a range of tools that enable AWS Support engineers to diagnose and solve customer problems, and we also produce and support customer-facing tools that are used for self-service, monitoring, learning, and using AWS. We're looking for a talented, passionate senior user experience researcher to work on internal tools, like case management and engineering support, and external tools, such as the Service Health Dashboard, Personal Health Dashboard, Support Center, Knowledge Center, AWS Forums, and Trusted Advisor. As a product experience researcher, you're comfortable discussing methodologies with the research team, and are equally comfortable discussing project road maps with executive leaders. You thrive on creating metrics, prioritization rubrics and business impact for research - all while sharing and communicating them to peers outside of the research and design community. Your research insights shape the way the organization understands and builds for our customers. You will have a significant impact on the creative direction of AWS Support products with an emphasis on solving major challenges and shaping the success of the customer experiences of AWS customers, internal service teams, and AWS Support engineers worldwide. Come join us and help create world-class customer support experiences for AWS. - Build a research road-map; communicate and refresh on regular basis to ensure relevancy. - Identify best method or mix of quantitative and qualitative methods based on research questions, timeline and resourcing. - Build and continuously improve a robust and thoughtful approach to gather customer insights and collaborate with other research teams in Amazon to align on best practice. - Designing, conducting, and analyzing results from a variety of research studies including usability lab studies, remote research, field studies and survey design. - Recruit and schedule usability participants for research studies. - Provide direction and vision for evolving the role of research in product development; identify opportunities to increase efficiency and impact. - Build positive, collaborative relationships across User Experience Design, Product Management, and Development teams. - Synthesize a wide range of primary and secondary data types to perform quick and thorough analyses leading to focused, insightful, and actionable findings. - Successfully persuade decision makers at all levels of the organization to take aligned action on research findings - inspire them and help them internalize opportunities to delight customers and differentiate our service. - Develop insight-based knowledge management frameworks to drive decision-making and prioritization of investments. Key job responsibilities The Data Center Construction Manager will be responsible for construction project management and oversight of construction related activities as they relate to new builds or general capital projects which includes the ownership of the project scope, quality, schedule, and budget. A day in the life Some of the typical daily tasks of the Construction Manager: Direct interface with construction general contractors during the bidding, award, execution, and project closeout/punch list phases. Conduct negotiations with general contractors and evaluate bids/proposals with detail and accuracy. Create construction project scope and request for proposals. Financial analysis of construction. Construction project management for specific initiatives aimed at increasing the resiliency of our data centers. Constructability reviews of electrical and mechanical designs associated with the construction of new data centers or optimization of existing data centers. Construction document management including submittal review, RFI's, change orders, and invoicing. Construction project quality control. Record and report key construction metrics to team members and management. Drive teams to perform troubleshooting and root-cause failure analysis associated with equipment failures. Be a leader within the group as well as within internal and external teams that support the data center. Able to read and interpret construction specifications and drawings for all disciplines. Define data center system-level architecture, specify/document performance and equipment requirements, create/communicate conceptual designs, and create/maintain project documentation. Experience with large scale technical operations or large-scale compute farms. Knowledge of building codes and regulations including Life Safety, BOCA, NFPA, NEC, and OSHA. Experience in controls and commissioning of large scale projects. Experience with power management and power monitoring systems. Certifications such as Professional Engineer (PE), LEED, and/or Certified Construction Manager (CCM) BASIC QUALIFICATIONS - Bachelor's degree in Electrical Engineering, Mechanical Engineering, or a related field - Experience in MS Excel, Word, and Windows Operating Systems - 5+ years of construction management of large, complex projects involving large-scale mechanical, electrical and plumbing (MEP) plants experience - Knowledge of electrical engineering principles including switchgear, UPS, transformers, and circuit breakers PREFERRED QUALIFICATIONS - 5+ years of project management in data centers or comparable critical infrastructure experience - Knowledge of critical data center equipment - Knowledge of engineering documentation, electrical diagrams and standard operating procedures - Knowledge of building codes and regulations including Life Safety, BOCA, NFPA, NEC, or OSHA - Experience in project management in data centers or comparable critical infrastructure - Experience in Data Center Engineering Operations, with a deep understanding of electrical and mechanical data center infrastructure - Experience reading and interpreting construction specifications and drawings for all domains Amazon is an equal opportunity employer and does not discriminate on the basis of protected veteran status, disability, or other legally protected status. Our inclusive culture empowers Amazonians to deliver the best results for our customers. If you have a disability and need a workplace accommodation or adjustment during the application and hiring process, including support for the interview or onboarding process, please visit for more information. If the country/region you're applying in isn't listed, please contact your Recruiting Partner. The base salary range for this position is listed below. Your Amazon package will include sign-on payments and restricted stock units (RSUs). Final compensation will be determined based on factors including experience, qualifications, and location. Amazon also offers comprehensive benefits including health insurance (medical, dental, vision, prescription, Basic Life & AD&D insurance and option for Supplemental life plans, EAP, Mental Health Support, Medical Advice Line, Flexible Spending Accounts, Adoption and Surrogacy Reimbursement coverage), 401(k) matching, paid time off, and parental leave. Learn more about our benefits at . USA, VA, Fredericksburg - 111 100.00 USD annually
08/19/2026
Full time
AWS Infrastructure Services owns the design, planning, delivery, and operation of all AWS global infrastructure. In other words, we're the people who keep the cloud running. We support all AWS data centers and all the servers, storage, networking, power, and cooling equipment that ensure our customers have continual access to the innovation they rely on. We work on the most challenging problems, with thousands of variables impacting the supply chain - and we're looking for talented people who want to help. You'll join a diverse team of software, hardware, and network engineers, supply chain specialists, security experts, operations managers, and other vital roles. You'll collaborate with people across AWS to help us deliver the highest standards for safety and security while providing seemingly infinite capacity at the lowest possible cost for our customers. And you'll experience an inclusive culture that welcomes bold ideas and empowers you to own them to completion. AWS is used by millions of users around the globe-from small start-ups to household names like Netflix and NASA-and AWS Support is one of the largest and fastest growing business units within AWS. Our team's goal is to innovate and to improve customer success, trust, and experiences with both AWS products and with AWS Support. Our team has the rare opportunity to support every service and every AWS account, and we are obsessed with creating exceptional customer experiences. Because of our team's broad mission and scope, we need a talented, passionate senior product experience designer who can create elegant, intuitive user interfaces and who has strong ideation skills, robust holistic systems thinking, deep attention to detail, and passion for turning difficult tasks into simple and delightful experiences for customers. We produce and support a range of tools that enable AWS Support engineers to diagnose and solve customer problems, and we also produce and support customer-facing tools that are used for self-service, monitoring, learning, and using AWS. We're looking for a talented, passionate senior user experience researcher to work on internal tools, like case management and engineering support, and external tools, such as the Service Health Dashboard, Personal Health Dashboard, Support Center, Knowledge Center, AWS Forums, and Trusted Advisor. As a product experience researcher, you're comfortable discussing methodologies with the research team, and are equally comfortable discussing project road maps with executive leaders. You thrive on creating metrics, prioritization rubrics and business impact for research - all while sharing and communicating them to peers outside of the research and design community. Your research insights shape the way the organization understands and builds for our customers. You will have a significant impact on the creative direction of AWS Support products with an emphasis on solving major challenges and shaping the success of the customer experiences of AWS customers, internal service teams, and AWS Support engineers worldwide. Come join us and help create world-class customer support experiences for AWS. - Build a research road-map; communicate and refresh on regular basis to ensure relevancy. - Identify best method or mix of quantitative and qualitative methods based on research questions, timeline and resourcing. - Build and continuously improve a robust and thoughtful approach to gather customer insights and collaborate with other research teams in Amazon to align on best practice. - Designing, conducting, and analyzing results from a variety of research studies including usability lab studies, remote research, field studies and survey design. - Recruit and schedule usability participants for research studies. - Provide direction and vision for evolving the role of research in product development; identify opportunities to increase efficiency and impact. - Build positive, collaborative relationships across User Experience Design, Product Management, and Development teams. - Synthesize a wide range of primary and secondary data types to perform quick and thorough analyses leading to focused, insightful, and actionable findings. - Successfully persuade decision makers at all levels of the organization to take aligned action on research findings - inspire them and help them internalize opportunities to delight customers and differentiate our service. - Develop insight-based knowledge management frameworks to drive decision-making and prioritization of investments. Key job responsibilities The Data Center Construction Manager will be responsible for construction project management and oversight of construction related activities as they relate to new builds or general capital projects which includes the ownership of the project scope, quality, schedule, and budget. A day in the life Some of the typical daily tasks of the Construction Manager: Direct interface with construction general contractors during the bidding, award, execution, and project closeout/punch list phases. Conduct negotiations with general contractors and evaluate bids/proposals with detail and accuracy. Create construction project scope and request for proposals. Financial analysis of construction. Construction project management for specific initiatives aimed at increasing the resiliency of our data centers. Constructability reviews of electrical and mechanical designs associated with the construction of new data centers or optimization of existing data centers. Construction document management including submittal review, RFI's, change orders, and invoicing. Construction project quality control. Record and report key construction metrics to team members and management. Drive teams to perform troubleshooting and root-cause failure analysis associated with equipment failures. Be a leader within the group as well as within internal and external teams that support the data center. Able to read and interpret construction specifications and drawings for all disciplines. Define data center system-level architecture, specify/document performance and equipment requirements, create/communicate conceptual designs, and create/maintain project documentation. Experience with large scale technical operations or large-scale compute farms. Knowledge of building codes and regulations including Life Safety, BOCA, NFPA, NEC, and OSHA. Experience in controls and commissioning of large scale projects. Experience with power management and power monitoring systems. Certifications such as Professional Engineer (PE), LEED, and/or Certified Construction Manager (CCM) BASIC QUALIFICATIONS - Bachelor's degree in Electrical Engineering, Mechanical Engineering, or a related field - Experience in MS Excel, Word, and Windows Operating Systems - 5+ years of construction management of large, complex projects involving large-scale mechanical, electrical and plumbing (MEP) plants experience - Knowledge of electrical engineering principles including switchgear, UPS, transformers, and circuit breakers PREFERRED QUALIFICATIONS - 5+ years of project management in data centers or comparable critical infrastructure experience - Knowledge of critical data center equipment - Knowledge of engineering documentation, electrical diagrams and standard operating procedures - Knowledge of building codes and regulations including Life Safety, BOCA, NFPA, NEC, or OSHA - Experience in project management in data centers or comparable critical infrastructure - Experience in Data Center Engineering Operations, with a deep understanding of electrical and mechanical data center infrastructure - Experience reading and interpreting construction specifications and drawings for all domains Amazon is an equal opportunity employer and does not discriminate on the basis of protected veteran status, disability, or other legally protected status. Our inclusive culture empowers Amazonians to deliver the best results for our customers. If you have a disability and need a workplace accommodation or adjustment during the application and hiring process, including support for the interview or onboarding process, please visit for more information. If the country/region you're applying in isn't listed, please contact your Recruiting Partner. The base salary range for this position is listed below. Your Amazon package will include sign-on payments and restricted stock units (RSUs). Final compensation will be determined based on factors including experience, qualifications, and location. Amazon also offers comprehensive benefits including health insurance (medical, dental, vision, prescription, Basic Life & AD&D insurance and option for Supplemental life plans, EAP, Mental Health Support, Medical Advice Line, Flexible Spending Accounts, Adoption and Surrogacy Reimbursement coverage), 401(k) matching, paid time off, and parental leave. Learn more about our benefits at . USA, VA, Fredericksburg - 111 100.00 USD annually
