Missouri Licensed Vice President of Utilization Management

Job Summary

A company is looking for a Vice President of Utilization Management.

Key Responsibilities

• Oversee operations of utilization management, including referral management and prior authorization across multiple product lines
• Develop and implement training programs for clinical and non-clinical staff in centralized and regional environments
• Ensure compliance with NCQA standards and collaborate with management on policies related to prior authorization and concurrent review

Required Qualifications

• Bachelor's Degree in Nursing or a related field, or equivalent experience
• 10+ years of experience in nursing, utilization management, or case management in an acute care setting
• Experience in a managed care environment
• Previous management experience with responsibilities for hiring, training, and managing staff performance
• Current state's nursing license preferred