Nevada Licensed Utilization Manager

Job Summary

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

Key Responsibilities

• Manage operational activities of Utilization Management and Appeals, including policy development and team metrics review
• Drive process improvement and oversee compliance with regulatory requirements
• Educate and mentor staff on operational procedures and facilitate interdepartmental collaboration

Required Qualifications, Training, and Education

• Degree or diploma in nursing is required
• A minimum of five (5) years of experience in Utilization Management or related operations is required
• Managed Care experience is required
• Experience with analysis, data, and reporting is required
• Current, unrestricted Registered Nurse (RN) licensure is required