Florida Licensed Utilization Management Director

Job Summary

Leading a remote team, the full-time Florida Licensed Utilization Management Director will oversee utilization management operations, ensuring compliance with policies and improving member outcomes through effective team management and strategic initiatives.

Key responsibilities

• Directs the utilization management team to enhance performance, compliance, and career development
• Reviews and analyzes utilization trends to implement effective management strategies and process improvements
• Manages departmental budget components and collaborates with senior leadership on operational strategies

Required qualifications

• Bachelor's degree with 7+ years of related experience, including management experience
• 4+ years of management experience preferred
• Expert knowledge of industry regulations, policies, and standards preferred
• Experience in Long-Term Care (LTC) Utilization Management and Medicaid managed care
• RN - Registered Nurse - State Licensure and/or Compact State Licensure preferred