Remote Director, Utilization Management – Long-Term Care

Centene; Florida; Remote; USD 122.000 - 225.000; Vollzeit

Benefits dieser Stelle

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off plus holidays

Flexible work schedules (remote,hybrid

Zusammenfassung

Centene is seeking a Director of Utilization Management in a remote-capable role based in Florida. You will lead the utilization management team to ensure policies are applied for optimal member outcomes, with emphasis on Long-Term Care UM and NCQA standards.

The role requires 7+ years of experience with prior management, a Bachelor's degree, and RN licensure is preferred. Competitive pay and flexible work options are offered.

Qualifikationen

• Bachelor's degree required.
• 7+ years of related experience required, including prior management experience.
• 4+ years of management experience preferred.
• RN licensure (preferred).

Aufgaben

• Lead the utilization management team on performance, improvement, and career growth.
• Ensure compliance with corporate, state, and NCQA standards.
• Review, analyze, and report on utilization trends and patterns.
• Lead process improvements for cost-effective healthcare results.
• Establish policies and procedures for effective utilization reviews.
• Develop utilization management strategies aligned with organizational objectives.
• Manage department budget components while collaborating with senior leadership.
• Oversee onboarding, hiring, and training of new team members.
• Manage others in a matrixed environment with tight deadlines.
• Champion change within the scope of responsibility.

Kenntnisse

Leadership

Utilization management

Team management

Ausbildung

Bachelor's degree

RN licensure (preferred)

Jobbeschreibung

Centene is seeking a Director of Utilization Management in a remote-capable role based in Florida. You will lead the utilization management team to ensure policies are applied for optimal member outcomes, with emphasis on Long-Term Care UM and NCQA standards.

The role requires 7+ years of experience with prior management, a Bachelor's degree, and RN licensure is preferred. Competitive pay and flexible work options are offered.