Talent.com
RN Licensed Utilization Management Director
RN Licensed Utilization Management DirectorVirtualVocations • Tampa, Florida, United States
RN Licensed Utilization Management Director

RN Licensed Utilization Management Director

VirtualVocations • Tampa, Florida, United States
30+ days ago
Job type
  • Full-time
Job description

A company is looking for a Director, Utilization Management Support Operations.

Key Responsibilities

Directs the utilization management team to ensure compliance with policies and procedures for optimal member outcomes

Reviews and analyzes utilization trends to enhance the effectiveness of the utilization program

Provides strategic leadership for the Peer-to-Peer Call Center, ensuring timely communication and operational efficiency

Required Qualifications

Bachelor's degree required

7+ years of related experience, including prior management experience

4+ years of management experience preferred

Expert knowledge of industry regulations and standards preferred

Healthcare background in a call center environment is highly preferred

Create a job alert for this search

Rn Utilization Management • Tampa, Florida, United States

Related jobs
Florida Licensed Utilization Management RN

Florida Licensed Utilization Management RN

VirtualVocations • Tampa, Florida, United States
Full-time
A company is looking for a Utilization Management Registered Nurse - Remote.Key Responsibilities Analyze patient records to determine the legitimacy of hospital admissions and appropriate levels ...Show more
Last updated: 30+ days ago • Promoted
Licensed Utilization Review Clinician

Licensed Utilization Review Clinician

VirtualVocations • Tampa, Florida, United States
Full-time
A company is looking for a Utilization Review Clinician - ABA.Key Responsibilities Evaluates member's care and health status related to Applied Behavioral Analysis (ABA) services to ensure medica...Show more
Last updated: 30+ days ago • Promoted
Delivery Driver - Sign Up in Minutes

Delivery Driver - Sign Up in Minutes

DoorDash • Lithia, FL, United States
Full-time +1
DoorDash is the #1 category leader in food delivery, food pickup, and convenience store delivery in the US, trusted by millions of customers every day. As a Dasher, you’ll stay busy with a var...Show more
Last updated: 30+ days ago • Promoted
California Licensed Utilization Management Nurse

California Licensed Utilization Management Nurse

VirtualVocations • Lakeland, Florida, United States
Full-time
A company is looking for a Utilization Management Nurse - LVN (Work from Home).Key Responsibilities Perform medical necessity reviews for assigned members Collaborate with the Medical Director o...Show more
Last updated: 25 days ago • Promoted
Ohio Licensed Utilization Management Nurse

Ohio Licensed Utilization Management Nurse

VirtualVocations • Tampa, Florida, United States
Full-time
A company is looking for a Utilization Management Nurse Consultant.Key Responsibilities Assess, plan, implement, coordinate, monitor, and evaluate healthcare services for members Gather clinical...Show more
Last updated: 30+ days ago • Promoted
Minnesota Licensed Utilization Review Nurse

Minnesota Licensed Utilization Review Nurse

VirtualVocations • Lakeland, Florida, United States
Full-time
A company is looking for a Utilization Review Nurse responsible for managing pre-claim prior authorization denials for pharmacy and medical benefits. Key Responsibilities Review and assess prior a...Show more
Last updated: 3 days ago • Promoted
Tennessee Licensed Utilization Review Clinician

Tennessee Licensed Utilization Review Clinician

VirtualVocations • Tampa, Florida, United States
Full-time
A company is looking for a Utilization Review Clinician - Behavioral Health.Key Responsibilities Evaluate member's treatment for mental health and substance abuse to ensure medical appropriatenes...Show more
Last updated: 6 days ago • Promoted
Director of Absence Management

Director of Absence Management

GIS National LLC • Saint Petersburg, FL, US
Full-time
The Director of Absence Management is responsible for staying up to date on all aspects of leave policies and programs across the United States. The Director will provide expert guidance and support...Show more
Last updated: 30+ days ago • Promoted
Supervisor, Utilization Management

Supervisor, Utilization Management

Toney Healthcare • Tampa, FL, US
Full-time
The Clinical Utilization Management (UM) Supervisor is responsible for overseeing daily operations of the Utilization Management team to ensure timely, accurate, and appropriate clinical decision-m...Show more
Last updated: 2 days ago • Promoted
Utilization Review Specialist

Utilization Review Specialist

LifePoint Health • Tampa, FL, United States
Full-time
At Tampa General Behavioral Health Hospital, we are committed to empowering and supporting a diverse and determined workforce who can drive quality, scalability, and significant impact across our h...Show more
Last updated: 4 days ago • Promoted
Restaurant Delivery - Sign Up in Minutes

Restaurant Delivery - Sign Up in Minutes

DoorDash • Odessa, FL, United States
Full-time +1
DoorDash is the #1 category leader in food delivery, food pickup, and convenience store delivery in the US, trusted by millions of customers every day. As a Dasher, you’ll stay busy with a var...Show more
Last updated: 30+ days ago • Promoted
DC Licensed Utilization Nurse Reviewer

DC Licensed Utilization Nurse Reviewer

VirtualVocations • Lakeland, Florida, United States
Full-time
A company is looking for a Utilization Nurse Reviewer (Remote).Key Responsibilities Conduct timely clinical chart reviews and communicate effectively with third-party payers Review admission ser...Show more
Last updated: 4 days ago • Promoted
Tennessee RN Utilization Review

Tennessee RN Utilization Review

VirtualVocations • Lakeland, Florida, United States
Full-time
A company is looking for an RN Utilization Review.Key Responsibilities Perform clinical assessments and evaluate injured employees' treatment utilization and compliance Collaborate with healthca...Show more
Last updated: 5 days ago • Promoted
Ohio Licensed Care Management Manager

Ohio Licensed Care Management Manager

VirtualVocations • Tampa, Florida, United States
Full-time
A company is looking for a Manager, Community-Based Care Management.Key Responsibilities Oversee a team of clinical and nonclinical staff to meet service level and production expectations Facili...Show more
Last updated: 5 days ago • Promoted
Ohio Licensed Utilization Management RN

Ohio Licensed Utilization Management RN

VirtualVocations • Tampa, Florida, United States
Full-time
A company is looking for a Utilization Management RN Reviewer.Key Responsibilities Conduct admission, concurrent, and retrospective reviews of patient charts and clinical systems Collaborate wit...Show more
Last updated: 5 days ago • Promoted
Hawaii Licensed Utilization Review Clinician

Hawaii Licensed Utilization Review Clinician

VirtualVocations • Tampa, Florida, United States
Full-time
A company is looking for a Utilization Review Clinician - Behavioral Health.Key Responsibilities Evaluates treatment for mental health and substance abuse to ensure medical appropriateness Perfo...Show more
Last updated: 4 days ago • Promoted
Maine Licensed Utilization Review Nurse

Maine Licensed Utilization Review Nurse

VirtualVocations • Tampa, Florida, United States
Full-time
A company is looking for a Utilization Review Nurse - Remote.Key Responsibilities Review prior authorization requests for medical necessity and manage medical claims disputes Coordinate transiti...Show more
Last updated: 30+ days ago • Promoted
Texas Licensed Concurrent Review RN

Texas Licensed Concurrent Review RN

VirtualVocations • Tampa, Florida, United States
Full-time
A company is looking for an RN Concurrent Review.Key Responsibilities Monitor and document medical treatment telephonically, ensuring compliance with established guidelines Track patient progres...Show more
Last updated: 5 days ago • Promoted