Florida Licensed Utilization Management VP - Memphis Tennessee

Company: VirtualVocations
Location: Memphis, Tennessee
Posted On: 01/29/2025

A company is looking for a VP of PHCO Utilization Management - Medicare & Duals.



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 settings
Ensure compliance with NCQA standards and collaborate with management on policies regarding 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, including hiring and training responsibilities
Current nursing license in the state of practice More...

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