Registered Nurse Operations Lead

Job Summary

Driving operational excellence, the full-time remote UM Operations Strategy Implementation Lead will oversee compliance activities, implement process improvements, and collaborate with various teams to enhance the Utilization Management department's effectiveness.

Key responsibilities:

• Utilize process controls to achieve operational excellence and close compliance variances
• Collaborate with analytics and clinical teams to ensure regulatory content is accurately represented in data sets
• Support change management initiatives and assist in the implementation of process improvements across the department

Required qualifications:

• Bachelor's degree in healthcare, population health, or related field, or equivalent experience
• Minimum of five years of experience in Utilization Management or related fields
• Current, unrestricted Registered Nurse (RN) licensure is preferred
• Experience with quality control and/or process standards is preferred
• Six Sigma or project management certifications are preferred