Director of Group Health

Job Responsibilities:

• Lead and oversee the Group Health Operations Management team, ensuring effective execution of utilization management services and operational workflows.
• Drive achievement of key client performance metrics, including turnaround time, quality indicators, peer-to-peer success rates, and overturn rates.
• Manage overall division profitability, including ownership of P&L performance and financial objectives.

Requirements:

• Bachelor’s or Master’s degree preferred; Registered Nurse (RN) required, preferably BSN or higher.
• 5–10 years of experience managing Utilization Management nursing teams within a health plan, IRO, or similar healthcare environment.
• Strong understanding of utilization management standards, guidelines, and healthcare review processes.

Benefits:

• Comprehensive medical, dental, and vision insurance coverage for employees and families.
• Employer-paid basic life insurance, short-term disability, and long-term disability coverage.
• 401(k) retirement plan with company match to support long-term financial planning.