UM Correspondence Director

7+ years of experience in healthcare operations, payer/provider communications, or utilization management 5+ years in a leadership role overseeing multi-disciplinary or matrixed teams Proven track record of building new functions and creating operational structure in ambiguous environments Understanding of healthcare regulatory and accreditation requirements (CMS, NCQA, URAC) Strong ability to translate complex business requirements into clear, actionable specifications for technical and operational teams Experience with automation technologies, letter management systems, and workflow platforms Exceptional communication and stakeholder management skills Demonstrated success in process improvement, QA, and audit readiness Master’s degree in healthcare administration, business, or related field preferred

Create and guide the Review Communications function, including vision, structure, and standards Build clear governance frameworks to ensure consistent tone, language, and quality Identify opportunities for automation and improved efficiency across communication workflows Provide direction and alignment across key teams involved in the communication process Oversee the end-to-end process for creating, testing, approving, and deploying communications Establish and maintain QA standards to ensure accuracy, audit readiness, and consistency Monitor performance, vendor outcomes, and key quality metrics to drive continuous improvement Mentor teammates and partners to promote transparency, accountability, and high-quality execution