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Supervisor | Utilization Management | RN

Orlando, FL

Supervisor | Utilization Management | RN

Job Description

Supervisor, UM - ORLANDO

Growing national MCO is adding to the leadership team in Orlando.

Supervise the daily operations of the utilization management (UM) staff. 

Ensure appropriate usage of resources in order to facilitate the UM process. 

Ensure compliance within applicable state program guidelines


Evaluate compliance policies and procedures and analyze/recommend enhancements


Assist with ensuring consistent data collection from UM staff that is used to assist the company in achieving corporate goals, to improve monitoring and reporting in order to meet external requirements


Identify opportunities for process improvements necessary to facilitate department functions


Educate staff as necessary to ensure consistent performance and adhere to standards


Assist UM Manager and Director with coordinating and facilitating system processes with providers, partners, vendors, and subcontractors as necessary



Job Requirements

Qualifications:

-3+ years of utilization management/quality improvement experience. 

-Working knowledge and understanding of basic utilization management and quality improvement concepts. 

-Previous experience as a lead in a functional area or managing cross functional teams on large scale projects. 

-FL LPN, LVN, or RN license.

About MMS Group

MMS is a Managed Care executive search firm. We are Managed Care's complete recruiting resource.

Keywords: nurse manager, nurse jobs near me, managed care, healthcare

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