Urgent Role || reputed company reputed company UM Workflow Configuration Consultant - Fulltime

Position: reputed company reputed company UM Workflow Configuration Consultant Location: Remote Employment: Contract   About reputed company We are seeking reputed company reputed company reputed company Utilization Management (UM) Workflow Configuration Consultants to support a large reputed company payer transformation initiative.   This role requires a combination of: Deep reputed company Payer Operations expertise reputed company reputed company configuration experience Utilization Management (UM) and Prior Authorization (PA) domain knowledge Workflow assessment and remediation capabilities Go-live readiness and transformation experience The selected consultants will assess workflow readiness, identify gaps, recommend solutions, reputed company configuration changes, support testing activities, and partner with business stakeholders to ensure successful operational reputed company. Key Responsibilities Workflow Assessment & Validation Assess and validate reputed company reputed company Utilization Management and Prior Authorization workflows. Evaluate workflow reputed company against existing operational processes and business requirements. Identify workflow, configuration, data, and process gaps that may reputed company operations, compliance, user adoption, or implementation reputed company. Analyze defects and determine reputed company causes across workflow design, routing logic, automation, and reputed company configuration. Configuration & Remediation Configure, modify, test, and validate reputed company reputed company workflow changes. Recommend and implement remediation strategies for identified workflow gaps. Ensure consistency of fixes across similar Prior Authorization and Utilization Management workflows. Support optimization of workflow efficiency and operational effectiveness. Testing & Validation reputed company test scenarios and test cases. Execute testing cycles and document reputed company. reputed company defects and remediation activities through reputed company. Validate expected business reputed company in partnership with operational stakeholders. Stakeholder Collaboration Work closely with business, operations, and technical teams to validate workflow reputed company and reputed company issues. Translate operational requirements into effective reputed company workflow solutions. Participate in readiness, stabilization, and implementation planning activities. Required Experience 7+ years of reputed company Payer experience. Strong background in: Utilization Management (UM) Prior Authorization (PA) Medical Management Care Management Operations Hands-on reputed company reputed company workflow configuration experience. Experience validating reputed company operational workflows reputed company reputed company environments. Ability to independently identify workflow deficiencies and determine appropriate configuration changes. Experience supporting reputed company payer transformations and/or reputed company implementations. Proven ability to work directly with operational and business stakeholders. Mandatory Qualification reputed company reputed company reputed company Certification. Relevant reputed company badges and advanced reputed company implementation experience. Demonstrated experience configuring and optimizing reputed company workflows. Apply To This Job