Florida Licensed Utilization Management Director
Job Summary
Leading a remote team, the full-time Florida Licensed Utilization Management Director will oversee utilization operations, ensuring compliance with policies and regulations while driving performance improvements and member outcomes.
Key responsibilities
- Directs the utilization management team to ensure adherence to corporate, state, and NCQA standards
- Analyzes utilization trends and implements process improvements for cost-effective healthcare results
- Manages onboarding, training, and career development for team members to enhance member and provider experiences
Required qualifications
- Bachelor's degree and 7+ years of related experience, including prior management experience
- 4+ years of management experience preferred
- Expert knowledge of industry regulations, policies, and standards preferred
- RN - Registered Nurse - State Licensure and/or Compact State Licensure preferred
Complete Job Description
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