State Licensed VP of Utilization Management
Company: VirtualVocations
Location: Lakeland
Posted on: January 27, 2025
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Job Description:
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
Keywords: VirtualVocations, Tampa , State Licensed VP of Utilization Management, Executive , Lakeland, Florida
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