Project Manager, Utilization Management (Remote)

Availity delivers revenue cycle and related business solutions for health care professionals who want to build healthy, thriving organizations. Availity has the powerful tools, actionable insights and expansive network reach that medical businesses need to get an edge in an industry constantly redefined by change.

At Availity, we're not just another Healthcare Technology company; we're pioneers reshaping the future of healthcare! With our headquarters in vibrant Jacksonville, FL, and an exciting office in Bangalore, India, along with an exceptional remote workforce across the United States, we're a global team united by a powerful mission.

We're on a mission to bring the focus back to what truly matters – patient care. As the leading healthcare engagement platform, we're the heartbeat of an industry that impacts millions. With over 2 million providers connected to health plans, and processing over 13 billion transactions annually, our influence is continually expanding.

Join our energetic, dynamic, and forward-thinking team where your ideas are celebrated, innovation is encouraged, and every contribution counts. We're transforming the healthcare landscape, solving communication challenges, and creating connections that empower the nation's premier healthcare ecosystem.

The Project Manager for Availity’s Utilization Management (UM) solution leads the planning, execution, and delivery of projects that drive transformative change in healthcare authorization workflows. This hybrid role combines project management and coordination across both technical and clinical domains, requiring close collaboration with engineering, product, and clinical operations teams to deliver real-time or near real-time prior authorization capabilities that integrate seamlessly into provider workflows. This position reports to the Medical Director of Availity’s Intelligent Utilization Management solution.

Sponsorship, in any form, is not available for this position.

To be qualified for this role, you have:

• Bachelor’s degree in Business, Project Management, Information Technology, Nursing, Engineering, or a related field.

• 3–7 years of experience in project management, coordinating cross-functional technical and clinical teams.

• Experience in healthcare technology, utilization management, or AI-driven solutions.

• Familiarity with healthcare authorization workflows, payer/provider operations, and regulatory requirements.

• Experience with project management tools (e.g., MS Project, Jira, Confluence, Smartsheet, Trello).

• Excellent organizational, time management, and prioritization skills.

• Strong communication and stakeholder management abilities.

• Ability to bridge technical and clinical domains effectively.

• Analytical and problem-solving mindset with attention to detail.

• Skilled at managing multiple concurrent projects in a fast-paced environment.

Nice to have:

• Familiarity with FHIR standards and healthcare interoperability concepts preferred.

• PMP, PRINCE2, Agile/Scrum, or other recognized project management certifications.

• Working knowledge of medical coding (CPT, ICD-10) and payer policy management processes.

What you'll do:

Product-Specific Project Leadership

• Define project scope, objectives, and deliverables in collaboration with stakeholders across the Intelligent Utilization Management organization.

• Develop and maintain detailed project plans, schedules, budgets, and resource allocations.

• Drive project execution to deliver real-time or near real-time prior authorization capabilities, integrating seamlessly into provider workflows.

Cross-Functional Collaboration

• Lead and motivate cross-functional team to ensure project milestones are met.

• Facilitate collaboration between technical, clinical, and business stakeholders to ensure policy-aligned, auditable, and scalable UM solutions.

• Communicate project goals, expectations, and updates clearly to all stakeholders.

Risk & Issue Management

• Identify potential risks and issues, implement mitigation strategies.

• Monitor project health, resolve obstacles, and escalate critical challenges to leadership as needed.

Reporting & Documentation

• Track progress and provide regular status reports to leadership and stakeholders.

• Maintain accurate project documentation and ensure compliance with organizational policies and standards.

Availity culture and benefits:

• Availity is a certified “Great Place to Work”, a “Best Workplaces for Technology Companies”, a “Best Workplaces for Women” and a “Best Workplaces for Millennials”!

• Culture is important to us and there are many ways for you to make your mark here!

• We have several Diversity & Inclusion teams and various ways to engage with fellow Availity associates. “AvaiLadies”, “Beyond Black”, “HOLA”, “Availity Pride”, “VetAvaility” a Young Professionals Group and “She Can Code IT” a group for women in tech are some of the groups you can get involved in.

• Availity is a culture of continuous learning. We have many resources and experts in our tech stack and in our industry that can help get you there too!

• We offer a competitive salary, bonus structure, generous HSA company contribution, healthcare, vision, dental benefits and a 401k match program that you can take advantage of on day one!

• We offer unlimited PTO for salaried associates + 9 paid holidays. Hourly associates start at 19 days of PTO and go up from there with all the same holiday benefits.

• Interested in wellness? We allow our associates to reimburse up to $250/year for gym memberships, participation in racing events, weight management programs, etc.

• Interested in furthering your education? We offer education reimbursement!

• Availity offers Paid Parental Leave for both moms and dads, both birth parents and adoptive parents.

• Want to work for an organization that gives back to the community? You’re at the right place! Availity partners with various organizations, both locally and nationally, to raise awareness, funds and morale as our staff members volunteer their time and funds to engage the organizations campaign.

Next steps:  
After you apply, you will receive text/email messages thanking you for applying and then you will continue to receive more text/email messages alerting you as to where you are in the recruitment process.  
  
Interview process:   

• Recruiter video interview (recorded)

• Manager video interview

• Panel video interview

• Interview with VP of Software Engineering

Video Camera Usage:

Availity fosters a collaborative and open culture where communication and engagement are central to our success.  As a remote first company, we are also camera-first and provide all associates with camera/video capability to simulate the office environment. If you are not able to use your camera for all virtual meetings, you should not apply for this role.

Having cameras on helps create a more connected, interactive, and productive environment, allowing teams to communicate more effectively and build stronger working relationships.  The usage of cameras also enhances security and protects sensitive company information. Video participation is required to ensure that only authorized personnel are present in meetings and to prevent unauthorized access, data breaches, preventing social engineering, or the sharing of confidential information with non-participants.

Disclaimers:

Availity is an equal opportunity employer and makes decisions in employment matters without regard to race, religious creed, color, age, sex, sexual orientation, gender identity, gender expression, genetic information, national origin, religion, marital status, medical condition, disability, military service, pregnancy, childbirth and related medical conditions, or any other classification protected by federal, state, and local laws and ordinances.

Availity is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

NOTICE: Federal law requires all employers to verify the identity and employment eligibility of all persons hired to work in the United States. When required by state law or federal regulation, Availity uses I-9, Employment Eligibility Verification in conjunction with E-Verify to determine employment eligibility. Learn more about E-Verify at http://www.dhs.gov/e-verify.

Click the links below to view Federal Employment Notices.

Family & Medical Leave Act  Equal Employment Law Poster  Pay Transparency  Employee Polygraph Protection Act  IER Right to Work Poster  Important Notice about Employee Rights to Organize and Bargain Collectively with Their Employers