Florida Licensed Vice President of Utilization Management

Job Summary

Providing strategic leadership in a remote, full-time capacity, the Florida Licensed Vice President of Utilization Management will plan and execute medical management utilization programs, ensuring compliance and cost efficiency while driving innovative solutions across the enterprise.

Key responsibilities

• Direct collaboration with cross-functional teams to enhance the utilization management program and strategy
• Lead data-driven decision-making to improve outcomes within utilization management teams
• Establish standard operating procedures and monitor service level agreements to ensure quality and compliance

Required qualifications

• Bachelor's Degree in Nursing or a related healthcare field; Master's Degree preferred
• 10+ years of experience in managed care, health plan, or provider network organizations
• Current nursing license required
• Experience with Managed Medicaid preferred
• Equivalent experience reflecting the required knowledge and skills may be considered