Nursing Licensed Vice President

Job Summary

A company is looking for a Staff Vice President, Utilization Management.

Key Responsibilities

• Plan and execute Medical Management utilization programs to meet health benefit ratio targets
• Lead data-driven decision-making to enhance utilization management outcomes
• Establish standard operating procedures and monitor service level agreements for UM programs

Required Qualifications

• Bachelor's degree in Nursing or related healthcare field; Master's preferred
• 10+ years of experience in managed care, health plans, or provider network organizations
• Experience with Managed Medicaid preferred
• Current nursing license preferred