Excellus Health Plan Inc.
Rochester, NY, USA
Job Description: Summary: This role provides strategic, clinical, and operational leadership for the Candesa Utilization Management (UM) program, driving innovation and ensuring strong alignment with organizational goals. As the senior clinical authority for Candesa UM, this position sets the vision for how clinical criteria, benefit strategies, and UM workflows are designed, governed, and executed. This position also serves as a key clinical advisor for external clients including sales support, guiding clients through implementation, and representing the UM program with credibility and expertise. Through strong cross‑functional leadership and clinical stewardship, the role ensures the Candesa UM program delivers high‑quality, accurate, and consistent utilization management outcomes that meet organizational and client goals. Essential Accountabilities: Lead the strategic planning, execution, and business objectives for the Candesa Utilization Management (UM) product....