About this role
Director, Utilization Management & Operational Integrity at Medical Mutual. Location: Brooklyn, Ohio, United States. Role: directing operations, overseeing staff, optimizing workflows Requirements: BScN required (Master's preferred). Requires RN license, 8+ years progressive utilization management experience with 5+ years in leadership, NCQA/CMS/HIPAA knowledge, Microsoft Office proficiency, and strong communication and process-improvement skills. Category: Healthcare Services - Nursing Seniority: Senior Level Tools: NCQA, CMS, HIPAA, EMR, Microsoft Office, Microsoft Outlook, Microsoft Excel, Microsoft PowerPoint, Microsoft Word, ICD-10, CPT, HCPCS Certifications: rn, ohio rn, multi-state rn compact Commitment: Full Time Workplace: Hybrid Languages: English