Nevada Licensed Utilization Supervisor

Virtual Vocations Inc

Supervising a remote team of clinical review professionals, the full-time Nevada Licensed Utilization Supervisor will manage prior authorization, concurrent review, and retrospective review processes, ensuring compliance with healthcare standards while collaborating to resolve complex member care issues. Key responsibilities: Monitors and tracks utilization management resources to ensure adherence to performance, compliance, quality, and efficiency standards Collaborates with the utilization management team to identify opportunities for process and quality improvements Evaluates team performance and provides coaching, guidance, and feedback to ensure adherence to quality and performance standards Required qualifications: Valid, active, and unrestricted Nevada Registered Nurse (RN) license or a Compact RN license with the willingness to apply for Nevada RN License Graduate of an Accredited School of Nursing or Bachelor's degree 4+ years of related experience in utilization management or clinical review Knowledge of utilization management principles preferred

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Vacancy posted 2 days ago

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