Nevada Licensed Utilization Manager

Job Summary

A company is looking for a Utilization Management Market Operations Manager.

Key Responsibilities

• Oversee operational activities of Utilization Management and Appeals, including policy development and team metrics review
• Drive process improvement initiatives and manage compliance with regulatory requirements
• Educate and mentor staff while managing relationships with internal and external partners to enhance collaboration

Required Qualifications, Training, and Education

• Degree or diploma in nursing is required
• Minimum of five years of experience in Utilization Management or related operations
• Managed Care experience is required
• Experience with data analysis and reporting is required
• Current, unrestricted Registered Nurse (RN) licensure is required