Registered Nurse Utilization Director

Job Summary

A company is looking for a Director of Utilization Management.

Key Responsibilities

• Oversee the end-to-end lifecycle of internal and external communications across Utilization Management
• Lead the utilization management team in performance improvement and compliance with standards
• Develop and implement strategies for effective utilization reviews and process improvements

Required Qualifications, Training, and Education

• Bachelor's degree and 7+ years of related experience, including management experience
• 4+ years of management experience preferred
• Expert knowledge of industry regulations, policies, and standards preferred
• Registered Nurse (RN) licensure preferred
• Experience with CMS & NCQA standards and proficiency in Microsoft Excel