Talent.com
Texas Licensed Clinical Nurse Director
Texas Licensed Clinical Nurse DirectorVirtualVocations • Saint Louis, Missouri, United States
serp_jobs.error_messages.no_longer_accepting
Texas Licensed Clinical Nurse Director

Texas Licensed Clinical Nurse Director

VirtualVocations • Saint Louis, Missouri, United States
job_description.job_card.variable_days_ago
serp_jobs.job_preview.job_type
  • serp_jobs.job_card.full_time
job_description.job_card.job_description

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

serp_jobs.job_alerts.create_a_job

Clinical Director • Saint Louis, Missouri, United States

Job_description.internal_linking.related_jobs
Delaware Licensed Clinical Review Nurse

Delaware Licensed Clinical Review Nurse

VirtualVocations • Saint Charles, Missouri, United States
serp_jobs.job_card.full_time
A company is looking for a Clinical Review Nurse - Prior Authorization.Key Responsibilities Analyzes prior authorization requests to determine medical necessity and appropriate level of care Pro...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_hours • serp_jobs.job_card.promoted • serp_jobs.job_card.new
Arizona Licensed Care Review Clinician

Arizona Licensed Care Review Clinician

VirtualVocations • Saint Louis, Missouri, United States
serp_jobs.job_card.full_time
A company is looking for a Care Review Clinician (RN).Key Responsibilities Assess services for members to ensure optimum outcomes and compliance with regulations Analyze clinical service request...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Director of Clinical Strategy

Director of Clinical Strategy

VirtualVocations • Saint Charles, Missouri, United States
serp_jobs.job_card.full_time
A company is looking for a Director, Clinical Strategy & Operations.Key Responsibilities Lead and develop a high-performing team focused on forecasting, scheduling, and productivity optimization ...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Clinical Director

Clinical Director

P4P • Saint Louis, MO, US
serp_jobs.job_card.full_time
We are a new and growing ABA therapy practice serving families across Missouri.We provide in-home, school-based, and telehealth ABA services for children and adolescents with autism and development...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Texas Licensed Clinical Quality Nurse

Texas Licensed Clinical Quality Nurse

VirtualVocations • Florissant, Missouri, United States
serp_jobs.job_card.full_time
A company is looking for a Clinical Quality Nurse Reviewer, Sr.Key Responsibilities Perform QA checks on complex clinical claim reviews Review and analyze claim data and medical records using ap...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_hours • serp_jobs.job_card.promoted • serp_jobs.job_card.new
California Licensed Clinical Case Consultant

California Licensed Clinical Case Consultant

VirtualVocations • Saint Charles, Missouri, United States
serp_jobs.job_card.full_time
A company is looking for a Registered Nurse - Clinical Case Consultant (CalAIM ECM Program).Key Responsibilities Provide clinical oversight and guidance to care coordinators and case managers, en...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_hours • serp_jobs.job_card.promoted • serp_jobs.job_card.new
Florida Licensed Behavioral Clinician

Florida Licensed Behavioral Clinician

VirtualVocations • Florissant, Missouri, United States
serp_jobs.job_card.full_time
A company is looking for a FL Licensed Clinician : RCSWI, LCSW, or LMFT in Behavioral Health.Key Responsibilities Provide customized care and treatment plans for patients based on their needs Coo...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_hours • serp_jobs.job_card.promoted • serp_jobs.job_card.new
State Licensed Director of Clinical Excellence

State Licensed Director of Clinical Excellence

VirtualVocations • Saint Charles, Missouri, United States
serp_jobs.job_card.full_time
A company is looking for a Director, Clinical Excellence (Post Acute, VBC).Key Responsibilities Lead the operational delivery of the post-acute care program to ensure coordinated patient transiti...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_hours • serp_jobs.job_card.promoted • serp_jobs.job_card.new
State Licensed Medical Director

State Licensed Medical Director

VirtualVocations • Saint Charles, Missouri, United States
serp_jobs.job_card.full_time
A company is looking for a Medical Director - Medicare (Medical Policy & Operations).Key Responsibilities Provide clinical expertise and business direction for medical management programs Suppor...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
State Licensed Clinical Reviewer

State Licensed Clinical Reviewer

VirtualVocations • Florissant, Missouri, United States
serp_jobs.job_card.full_time
A company is looking for a Clinical Reviewer to perform Utilization Management and review clinical information for service requests. Key Responsibilities Evaluate referral appropriateness for serv...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Oregon Licensed Clinical Supervisor

Oregon Licensed Clinical Supervisor

VirtualVocations • Saint Louis, Missouri, United States
serp_jobs.job_card.full_time
A company is looking for a Clinical Supervisor - OR - LPC or LCSW - Remote.Key Responsibilities Provide supervision to a minimum of six resident clinicians, including weekly group and individual ...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_hours • serp_jobs.job_card.promoted • serp_jobs.job_card.new
Florida Licensed Behavioral Health Director

Florida Licensed Behavioral Health Director

VirtualVocations • Saint Charles, Missouri, United States
serp_jobs.job_card.full_time
A company is looking for a Senior Director, Behavioral Health Utilization Management.Key Responsibilities Leads and directs the behavioral health utilization management team to ensure appropriate...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_days • serp_jobs.job_card.promoted
Texas Licensed RN Manager

Texas Licensed RN Manager

VirtualVocations • Florissant, Missouri, United States
serp_jobs.job_card.full_time
A company is looking for a Manager of Prior Authorization UM - Aetna Medicaid Texas - RN.Key Responsibilities Lead and manage the prior authorization team, including hiring, training, and perform...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_hours • serp_jobs.job_card.promoted • serp_jobs.job_card.new
Licensed Medical Director

Licensed Medical Director

VirtualVocations • Florissant, Missouri, United States
serp_jobs.job_card.part_time
A company is looking for a part-time Medical Director with expertise in psychiatry.Key Responsibilities Oversee the quality and safety of psychiatric care and medication management services Enga...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_variable_hours • serp_jobs.job_card.promoted • serp_jobs.job_card.new
Arizona Licensed Clinical Review Nurse

Arizona Licensed Clinical Review Nurse

VirtualVocations • Saint Louis, Missouri, United States
serp_jobs.job_card.full_time
A company is looking for a Clinical Review Nurse - Concurrent Review.Key Responsibilities Performs concurrent reviews to determine overall health and appropriate level of care for members Review...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Medical Director - Colorado Licensed

Medical Director - Colorado Licensed

VirtualVocations • Saint Charles, Missouri, United States
serp_jobs.job_card.full_time
A company is looking for a Medical Director - Post-Acute Care Management - Care Transitions.Key Responsibilities Provide daily utilization oversight and communication with network physicians and ...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_1_day • serp_jobs.job_card.promoted
Arizona Licensed Clinical Systems Director

Arizona Licensed Clinical Systems Director

VirtualVocations • Florissant, Missouri, United States
serp_jobs.job_card.full_time
A company is looking for a Director, Clinical Systems.Key Responsibilities Lead and direct a team supporting clinical systems and oversee the system development lifecycle (SDLC) Manage the creat...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_1_day • serp_jobs.job_card.promoted
Ohio Licensed Medical Director

Ohio Licensed Medical Director

VirtualVocations • Saint Charles, Missouri, United States
serp_jobs.job_card.full_time
A company is looking for a Medspa Medical Director licensed in Ohio, Texas, or North Carolina.Key Responsibilities Review SOPs, consent forms, charts, etc Be on call in case of emergency Provid...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted
Virginia Licensed LTSS Medical Director

Virginia Licensed LTSS Medical Director

VirtualVocations • Florissant, Missouri, United States
serp_jobs.job_card.full_time
A company is looking for a Medical Director Remote.Key Responsibilities Conduct medical necessity reviews for LTSS / HCBS authorization requests Ensure all reviews meet federal and state complianc...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_1_day • serp_jobs.job_card.promoted
Washington Licensed Assistant Medical Director

Washington Licensed Assistant Medical Director

VirtualVocations • Florissant, Missouri, United States
serp_jobs.job_card.full_time
A company is looking for an Assistant Medical Director (Oncologist).Key Responsibilities Support clinical review activities and make final coverage decisions based on medical necessity Utilize c...serp_jobs.internal_linking.show_more
serp_jobs.last_updated.last_updated_30 • serp_jobs.job_card.promoted