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Utilization Management Assistant Jobs in Boston, MA

AdviniaCare

Assistant Case Manager

Salem, MA · On-site

) Assistant Case Manager Job Summary: We are seeking an experienced and detail-oriented Assistant ... companies for utilization review purposes * Track and schedule all certifications and ...

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All JobsUtilization Management JobsUtilization Management Assistant JobsUtilization Management Assistant Jobs in Boston, MA

Utilization Management Assistant information

See Boston, MA salary details

$31.5K

$52.6K

$75.5K

How much do utilization management assistant jobs pay per year?

As of Jul 26, 2026, the average yearly pay for utilization management assistant in Boston, MA is $52,571.00, according to ZipRecruiter salary data. Most workers in this role earn between $45,600.00 and $52,700.00 per year, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Utilization Management Assistant, and why are they important?

To thrive as a Utilization Management Assistant, you need a solid understanding of healthcare processes, medical terminology, and administrative procedures, often supported by a high school diploma or associate's degree. Familiarity with electronic health records (EHR) systems, insurance verification tools, and Microsoft Office Suite is typically required. Strong organizational skills, attention to detail, and effective communication are crucial soft skills for managing documentation and collaborating with clinical teams. These skills ensure accurate data handling, efficient workflow, and compliance with healthcare regulations, all of which are vital for successful utilization management operations.

What are some common challenges Utilization Management Assistants face when working with insurance pre-authorizations?

Utilization Management Assistants often encounter challenges such as navigating complex insurance requirements, meeting tight deadlines for pre-authorization requests, and communicating effectively with both healthcare providers and insurance representatives. Staying organized and detail-oriented is essential to ensure all documentation is accurate and submitted promptly. Additionally, adapting to frequent changes in insurance policies and maintaining strong problem-solving skills are key to overcoming these obstacles.

What is a Utilization Management Assistant?

A Utilization Management Assistant is a healthcare administrative professional who supports the utilization management team by handling clerical tasks, coordinating communications, and organizing patient documentation. They often help ensure that medical services are used efficiently and that insurance requirements are met by gathering information, processing authorizations, and maintaining records. This role is essential in facilitating collaboration between healthcare providers, insurance companies, and patients, ultimately helping to optimize the quality and cost-effectiveness of patient care.
What are the most commonly searched types of Utilization Management jobs in Boston, MA? The most popular types of Utilization Management jobs in Boston, MA are:
Utilization Management Assistant jobs near you
Infographic showing various Utilization Management Assistant job openings in Boston, MA as of July 2026, with employment types broken down into 1% As Needed, 76% Full Time, 19% Part Time, 1% Temporary, and 3% Contract. Highlights an 96% Physical, 2% Hybrid, and 2% Remote job distribution, with an average salary of $52,571 per year, or $25.3 per hour.
Senior AI & Utilization Management Product Manager

Senior AI & Utilization Management Product Manager

Newfire Global Partners

Boston, MA • Remote

$150K - $181K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 28 days ago

Job description

Job Title: Senior AI & Utilization Management Product Manager 
Track: Individual Contributor (IC)
Experience: 7 - 10 years 
Department: Product Management 
Location:  Care Lumen | Remote (US Only)  
Reports to: Director, Product Management 
Salary Range: $150000 - $181000 
Bonus (if applicable): 10% 
 
Scope 
We're seeking an experienced Senior Product Manager to drive innovation in our Utilization Management (UM) platform, with a specific focus on leveraging AI technology to transform how clinicians perform medical necessity reviews. You'll own the product strategy and roadmap for our member clinical documentation system, working to dramatically reduce administrative burden while maintaining clinical quality and compliance.  This role translates complex healthcare needs into scalable, secure, and compliant solutions that support real-world care and operations. The role is expected to operate with high autonomy, manage complex problem spaces, and apply strong product judgment to navigate ambiguity and trade-offs. 
Serving as a strategic owner and connector, the Senior Product Manager drives clarity and alignment across teams and partners with leadership to ensure product priorities support organizational goals. This is an individual contributor role with significant cross-functional influence. 
  • Define and evolve product roadmaps, requirements, and success metrics grounded in user insights, healthcare domain understanding, and data 
  • Lead discovery and delivery efforts that translate validated user needs into meaningful clinical, operational, and customer outcomes 
  • Drive the integration of AI/ML capabilities to automate clinical documentation extraction, summarization, and decision support 
  • Collaborate with data science and engineering teams to develop and refine AI models that assist with medical necessity determinations 
  • Design intelligent workflows that surface relevant clinical information and reduce manual chart review time 
  • Evaluate emerging AI technologies and vendors to inform build-vs-buy decisions 
  • Own product direction and the end-to-end lifecycle for a major product line or module from discovery through delivery and outcome measurement 
  • Drive cross-functional alignment by clarifying goals, framing trade-offs, and grounding decisions in data across engineering, design, and partner teams 
  • Measure and optimize product performance by defining KPIs, monitoring results, and iterating based on insights and feedback 
  • Partner closely with Customer Support, Implementation teams, and Clinical SMEs to support adoption, usability, and customer outcomes 
  • Identify and advance opportunities for improvement and innovation informed by customer needs, market trends, and evolving healthcare models 
  • Model strong product practices and elevate execution quality through influence, feedback, and shared standards. 

  • 7-10 years of product management experience, including ownership of complex product areas in health tech, healthcare IT, or similarly regulated domains 
  • Demonstrated ability to own and deliver products end-to-end in complex, regulated environments, from discovery through launch and iteration 
  • Strong understanding of healthcare ecosystems, including clinical workflows, customer segments, and regulatory context 
  • Proven experience applying hypothesis-driven discovery and outcome-oriented development to drive meaningful product decisions 
  • Deep familiarity with healthcare security, privacy, and compliance standards, and experience embedding these considerations throughout the product lifecycle 
  • Strong product judgment and analytical skills, with the ability to translate domain complexity into clear priorities, trade-offs, and measurable outcomes 
  • Excellent communication and stakeholder leadership skills, with a track record of influencing cross-functional teams without direct authority 
  • Experience working closely with cross-functional teams including Engineering, Design, Data, and customer-facing partners in fast-paced environments 
  • Experience building SaaS products in healthcare, with exposure to analytics, AI-enabled features, or population health solutions preferred 
 
Preferred 
  • Familiarity with regulatory requirements (NCQA UM standards, state regulations, CMS guidelines) 
  • Experience with HIPAA-compliant AI implementations and healthcare data governance 


Compensation & Benefits 
The expected total cash compensation for this role is market-driven, with an expected starting salary of $150,000 - $181,000. Salary is ultimately determined based on a candidate's skills, expertise, and experience. 

Care Lumen offers a robust and comprehensive benefits package including: 
  • Remote-first environment with company provided computer 
  • Thirteen paid holidays per year (average) 
  • Medical, dental and vision coverage with multiple levels of coverage 
  • HSA, FSA and Dependent Care accounts 
  • Short-term and Long-term disability 
  • Life and accidental death insurance 
  • Discounted voluntary benefits, such as additional life insurance 
  • Employee Assistance Program 
  • Paid Parental Leave 
  • Flexible vacation time 
  • 401(k) with employer matching and immediate vesting 
Offers are contingent upon successful completion of a background screening. Background screenings will be conducted in compliance with applicable laws and will not be initiated without your consent. 

Care Lumen is an equal opportunity employer committed to building a diverse and inclusive workplace. We do not discriminate on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, disability status, age, or any other legally protected status. 

We are committed to providing reasonable accommodations to qualified individuals with disabilities in our job application process. If you need assistance or an accommodation due to a disability, please contact us at apply@carelumen.com. 

About Care Lumen 
Care Lumen is transforming healthcare by connecting people, care, and data-so that every decision leads to better outcomes. We empower care teams with a unified platform that delivers intelligent, real-time insights, streamlined workflows, and stronger collaboration across clinical, operational, and administrative domains. 
Our vision is bold: to reimagine how care is delivered by unifying clinical operations and unlocking insights that improve lives. We believe in the power of great people and purposeful technology-and with all of us aligned around a common goal, our potential grows even stronger. We're building for impact today and evolving through innovation tomorrow. 

We're a remote-first company that values flexibility, autonomy, and results over hours logged. We're guided by values that push us to excel, stay curious, and take smart risks. The best solutions come from teams that listen, learn, and build together. And we're focused on outcomes that matter-not just for our clients, but for the people they serve. 

Care Lumen's LinkedIn
Care Lumen's website

Process - What to Expect 
Our hiring process typically includes: 
  1. Applied 
  2. Recruiter Interview 
  3. Hiring Manager Interview 
  4. Second Hiring Manager Interview 
  5. Panel Interview 
  6. Second Panel Interview 
  7. Offer 
  8. Background Check 
  9. Hired - Welcome to Care Lumen! 

Apply