State Licensed VP of Utilization Management - Fresno California

Company: VirtualVocations
Location: Fresno, California
Posted On: 01/29/2025

A company is looking for a VP of PHCO Utilization Management for Medicaid & Marketplace.



Key Responsibilities

Oversee operations of utilization management, including referral management and prior authorization across multiple product lines
Develop and implement clinical and non-clinical training programs for centralized and multi-site environments
Ensure compliance with NCQA standards and collaborate with management on policies related to utilization management functions


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, including hiring and performance management of staff
Current state's nursing license More...

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