Texas Licensed Clinical Nurse DirectorVirtualVocations • Gainesville, Florida, United States
Texas Licensed Clinical Nurse Director
VirtualVocations • Gainesville, Florida, United States
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A company is looking for a Director of Utilization Management.
Key Responsibilities
Develop and implement strategic plans for Utilization Management aligned with organizational goals
Direct all UM activities including prior authorization, concurrent review, and appeals
Ensure compliance with NCQA standards and lead accreditation activities
Required Qualifications
Bachelor's degree in Nursing, Healthcare Administration, or related field required
Master's degree in a related field preferred
Active RN license or other clinical licensure required
8-10 years of experience in utilization management or medical management
5 years in a leadership role overseeing UM operations
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