Arizona Licensed RN Medical Director

Job Summary

A company is looking for an Associate Director of Registered Nurse Medical Management Services.

Key Responsibilities

• Lead teams of RN Prior Authorization Review Nurses and LPNs, ensuring effective workflow and performance
• Assist in audits for Medicare Advantage and commercial insurance plans, ensuring compliance with standards
• Analyze healthcare data and trends to improve outcomes and implement departmental processes aligned with strategic initiatives

Required Qualifications

• Bachelor's degree in nursing or a related healthcare field, or equivalent experience
• Current Registered Nurse (R.N.) license in the state of residence
• Extensive knowledge in case management and utilization management
• Strong leadership skills with the ability to interact effectively across departments and organizations
• Understanding of hospital operations and reimbursement methodologies