{"schemaVersion":"jobsearcher.job.v1","id":"59c0ed13ffd6c0598f74adde","url":"https://jobsearcher.com/jobs/59c0ed13ffd6c0598f74adde","canonicalUrl":"https://jobsearcher.com/jobs/59c0ed13ffd6c0598f74adde","title":"Utilization Management Program Analyst","description":"About Curative\r\nCurative is building the future of health insurance with a first-of-its-kind employer-based plan designed to remove financial barriers and make care truly accessible: one monthly premium with $0 copays and $0 deductibles*.\r\nBacked by our recent $150M in Series B funding and valuation at $1.275B , Curative is scaling rapidly and investing in AI-powered service, deeper member engagement, and a smart network designed for today's workforce.\r\nOur north star guides everything we do: healthcare only works when people can actually use it . That belief drives every decision we make: from how we design our plan, support our members, to how we collaborate as a team.\r\nIf you want to do meaningful work with a team that moves fast, experiments boldly, and cares deeply, Curative is the place to do it. We're growing fast and looking for teammates who want to help transform health insurance for the better.\r\nSummary\r\nThe Utilization Management Program Analyst supports the development, implementation, and ongoing optimization of the organization's utilization management (UM) program. This role partners with clinical leadership, pharmacy, medical policy, and operational teams to evaluate prior authorization requirements, support medical policy implementation, maintain UM program documentation, and analyze utilization trends. The position plays an important role in ensuring the effectiveness, compliance, and continuous improvement of the UM program by assessing approval and denial patterns, supporting policy updates, coordinating responses to regulatory and audit requests, and assisting with cross-functional training initiatives.\r\nEssential Duties And Responsibilities\r\nUtilization Management Program Support\r\nSupport the ongoing development, implementation, and evaluation of the Utilization Management program\r\nAnalyze utilization trends and identify opportunities to add, modify, or remove procedure codes from prior authorization requirements\r\nMonitor and evaluate approval and denial rates, utilization patterns, and cost trends\r\nConduct cost and utilization analyses to assess the impact of UM policies and program changes\r\nProvide data-driven insights to support program improvements and operational decision-making\r\nUM Policy & Program Documentation\r\nSupport the maintenance and periodic updates of UM policies and procedures\r\nAssist with updates to the Utilization Management Program Description, including annual review and revisions\r\nEnsure alignment between UM policies, medical policies, and prior authorization requirements\r\nCoordinate internal review and documentation of policy updates with relevant stakeholders\r\nMedical Policy Implementation\r\nSupport implementation of facility medical policies within UM processes and workflows\r\nCollaborate with clinical and operational teams to ensure policies are operationalized effectively\r\nAssist with communication and documentation related to policy changes\r\nRegulatory & Audit Support\r\nCoordinate responses to regulatory requests, audits, and external inquiries\r\nMaintain documentation supporting UM compliance and regulatory requirements\r\nMonitor regulatory updates that may impact UM policies or operational practices\r\nClinical Licensure & Compliance Tracking\r\nTrack and maintain documentation for clinical licensure requirements related to UM activities\r\nSupport compliance with state and regulatory requirements regarding clinical participation in UM processes\r\nTraining & Cross-Functional Collaboration\r\nSupport development and coordination of training for pharmacy and medical teams\r\nAssist in creating training materials related to UM policies, workflows, and regulatory requirements\r\nServe as a liaison between UM, pharmacy, clinical, compliance, and operational teams\r\nProgram Coordination\r\nAssist with coordination of UM program initiatives and projects\r\nTrack deliverables, timelines, and implementation activities\r\nSupport reporting and documentation related to UM program performance\r\nAssist department leadership with day-to-day team management and administrative tasks. Work adhering to US regulatory and Quality System requirements (21 CFR 820, etc).\r\nThis position assumes and performs other duties as assigned.\r\nQualifications\r\nTo perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions:\r\nDemonstrated ability to manage projects, interpret data, and communicate effectively with stakeholders.\r\nFamiliarity with medical coding systems (CPT, HCPCS, ICD-10)\r\nExperience supporting prior authorization programs or utilization management processes\r\nExperience with data analysis, reporting, or cost/utilization analysis\r\nStrong organizational skills and attention to detail.\r\nAbility to work independently and take initiative.\r\nEDUCATION And/or EXPERIENCE\r\nBachelor's degree in healthcare administration, public health, health policy, business, or related field  2–5 years of experience in utilization management, healthcare operations, medical policy, or healthcare analytics\r\nMinimum of two years of experience in related role within a healthcare or medical management setting.\r\nWORK ENVIRONMENT\r\nWhile performing the duties of this Job, the employee is regularly required to sit; use hands to handle or feel; talk; and hear.\r\nSpecific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.\r\nThis is a remote position.\r\nThe employee may regularly be required to lift and/or move up to: 25 LBS.\r\nThe noise level in the work environment is usually: Mild.\r\nFor this position the percentage of expected Travel is: 5% of the time.\r\nPerks & Benefits\r\nCurative Health Plan (100% employer-covered medical premiums for you and 50% coverage for dependents on the base plan.)\r\n$0 copays and $0 deductibles (with completion of our Baseline Visit)\r\nPreventive and primary care built-in\r\nMental health support (Rula, Televero, Two Chairs, Recovery Unplugged)\r\nOne-on-one care navigation\r\nChronic condition programs (diabetes, weight, hypertension)\r\nMaternity and family planning support\r\n24/7/365 Curative Telehealth\r\nPharmacy benefits\r\nComprehensive dental and vision coverage\r\nEmployer-provided life and disability coverage with additional supplemental options\r\nFlexible spending accounts\r\nFlexible work options: remote and in-person opportunities\r\nGenerous PTO policy plus 11 paid annual company holidays\r\n401(k) for full-time employees\r\nGenerous up to 8–12 weeks paid parental leave, based on role eligibility.\r\nJ-18808-Ljbffr","company":"Curative","rawCompany":"curative","city":"Austin","state":"TX","isRemote":false,"isActive":false,"createdAt":"2026-04-09T09:14:51.708Z","occupations":[{"code":"11-9111.00","title":"Medical and Health Services Managers","slug":"medical-and-health-services-managers"},{"code":"13-1082.00","title":"Project Management Specialists","slug":"project-management-specialists"},{"code":"13-1111.00","title":"Management Analysts","slug":"management-analysts"}],"industries":[{"code":"524114","title":"Direct Health and Medical Insurance Carriers","slug":"direct-health-and-medical-insurance-carriers"},{"code":"524292","title":"Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds","slug":"pharmacy-benefit-management-and-other-third-party-administration-of-insurance-and-pension-funds"},{"code":"621111","title":"Offices of Physicians (except Mental Health Specialists)","slug":"offices-of-physicians-except-mental-health-specialists"}],"jobPosting":{"@context":"https://schema.org","@type":"JobPosting","title":"Utilization Management Program Analyst","description":"About Curative\r\nCurative is building the future of health insurance with a first-of-its-kind employer-based plan designed to remove financial barriers and make care truly accessible: one monthly premium with $0 copays and $0 deductibles*.\r\nBacked by our recent $150M in Series B funding and valuation at $1.275B , Curative is scaling rapidly and investing in AI-powered service, deeper member engagement, and a smart network designed for today's workforce.\r\nOur north star guides everything we do: healthcare only works when people can actually use it . That belief drives every decision we make: from how we design our plan, support our members, to how we collaborate as a team.\r\nIf you want to do meaningful work with a team that moves fast, experiments boldly, and cares deeply, Curative is the place to do it. We're growing fast and looking for teammates who want to help transform health insurance for the better.\r\nSummary\r\nThe Utilization Management Program Analyst supports the development, implementation, and ongoing optimization of the organization's utilization management (UM) program. This role partners with clinical leadership, pharmacy, medical policy, and operational teams to evaluate prior authorization requirements, support medical policy implementation, maintain UM program documentation, and analyze utilization trends. The position plays an important role in ensuring the effectiveness, compliance, and continuous improvement of the UM program by assessing approval and denial patterns, supporting policy updates, coordinating responses to regulatory and audit requests, and assisting with cross-functional training initiatives.\r\nEssential Duties And Responsibilities\r\nUtilization Management Program Support\r\nSupport the ongoing development, implementation, and evaluation of the Utilization Management program\r\nAnalyze utilization trends and identify opportunities to add, modify, or remove procedure codes from prior authorization requirements\r\nMonitor and evaluate approval and denial rates, utilization patterns, and cost trends\r\nConduct cost and utilization analyses to assess the impact of UM policies and program changes\r\nProvide data-driven insights to support program improvements and operational decision-making\r\nUM Policy & Program Documentation\r\nSupport the maintenance and periodic updates of UM policies and procedures\r\nAssist with updates to the Utilization Management Program Description, including annual review and revisions\r\nEnsure alignment between UM policies, medical policies, and prior authorization requirements\r\nCoordinate internal review and documentation of policy updates with relevant stakeholders\r\nMedical Policy Implementation\r\nSupport implementation of facility medical policies within UM processes and workflows\r\nCollaborate with clinical and operational teams to ensure policies are operationalized effectively\r\nAssist with communication and documentation related to policy changes\r\nRegulatory & Audit Support\r\nCoordinate responses to regulatory requests, audits, and external inquiries\r\nMaintain documentation supporting UM compliance and regulatory requirements\r\nMonitor regulatory updates that may impact UM policies or operational practices\r\nClinical Licensure & Compliance Tracking\r\nTrack and maintain documentation for clinical licensure requirements related to UM activities\r\nSupport compliance with state and regulatory requirements regarding clinical participation in UM processes\r\nTraining & Cross-Functional Collaboration\r\nSupport development and coordination of training for pharmacy and medical teams\r\nAssist in creating training materials related to UM policies, workflows, and regulatory requirements\r\nServe as a liaison between UM, pharmacy, clinical, compliance, and operational teams\r\nProgram Coordination\r\nAssist with coordination of UM program initiatives and projects\r\nTrack deliverables, timelines, and implementation activities\r\nSupport reporting and documentation related to UM program performance\r\nAssist department leadership with day-to-day team management and administrative tasks. Work adhering to US regulatory and Quality System requirements (21 CFR 820, etc).\r\nThis position assumes and performs other duties as assigned.\r\nQualifications\r\nTo perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions:\r\nDemonstrated ability to manage projects, interpret data, and communicate effectively with stakeholders.\r\nFamiliarity with medical coding systems (CPT, HCPCS, ICD-10)\r\nExperience supporting prior authorization programs or utilization management processes\r\nExperience with data analysis, reporting, or cost/utilization analysis\r\nStrong organizational skills and attention to detail.\r\nAbility to work independently and take initiative.\r\nEDUCATION And/or EXPERIENCE\r\nBachelor's degree in healthcare administration, public health, health policy, business, or related field  2–5 years of experience in utilization management, healthcare operations, medical policy, or healthcare analytics\r\nMinimum of two years of experience in related role within a healthcare or medical management setting.\r\nWORK ENVIRONMENT\r\nWhile performing the duties of this Job, the employee is regularly required to sit; use hands to handle or feel; talk; and hear.\r\nSpecific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.\r\nThis is a remote position.\r\nThe employee may regularly be required to lift and/or move up to: 25 LBS.\r\nThe noise level in the work environment is usually: Mild.\r\nFor this position the percentage of expected Travel is: 5% of the time.\r\nPerks & Benefits\r\nCurative Health Plan (100% employer-covered medical premiums for you and 50% coverage for dependents on the base plan.)\r\n$0 copays and $0 deductibles (with completion of our Baseline Visit)\r\nPreventive and primary care built-in\r\nMental health support (Rula, Televero, Two Chairs, Recovery Unplugged)\r\nOne-on-one care navigation\r\nChronic condition programs (diabetes, weight, hypertension)\r\nMaternity and family planning support\r\n24/7/365 Curative Telehealth\r\nPharmacy benefits\r\nComprehensive dental and vision coverage\r\nEmployer-provided life and disability coverage with additional supplemental options\r\nFlexible spending accounts\r\nFlexible work options: remote and in-person opportunities\r\nGenerous PTO policy plus 11 paid annual company holidays\r\n401(k) for full-time employees\r\nGenerous up to 8–12 weeks paid parental leave, based on role eligibility.\r\nJ-18808-Ljbffr","datePosted":"2026-04-09T09:14:51.708Z","dateModified":"2026-04-09T09:14:51.708Z","hiringOrganization":{"@type":"Organization","name":"Curative","sameAs":"https://jobsearcher.com"},"jobLocation":{"@type":"Place","address":{"@type":"PostalAddress","addressLocality":"Austin","addressRegion":"TX","addressCountry":"US"}},"identifier":{"@type":"PropertyValue","name":"JobSearcher","value":"59c0ed13ffd6c0598f74adde"},"url":"https://jobsearcher.com/jobs/59c0ed13ffd6c0598f74adde"}}