RN Utilization Management Manager — Hybrid Leader

University of California San Diego

San Diego (CA)

Hybrid

USD 132,600 - 259,800

Full time

14 days+
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Job summary

The University of California San Diego is looking for a Manager of Utilization Management. In this role, you will supervise Nurse Case Managers and Referral Coordinators ensuring compliance with regulations. You'll be responsible for overseeing department operations, analyzing data, and coaching team members.

The ideal candidate should possess a Bachelor's degree in nursing, be a Registered Nurse in California, with at least five years of relevant experience. The position offers a hybrid work schedule with the option to work in the office 1-2 days per week following orientation.

Qualifications

  • Five or more years of relevant experience including 3-5 years within IPA/MSO or Health Plan/HMO.
  • Experience with Commercial and Medicare lines of business.
  • Strong hands-on experience with prior authorization review process.

Responsibilities

  • Oversees day-to-day department operations and prioritizes team workload.
  • Collects and reports data on UM processes and results.
  • Collaborates on operational and performance issues for UM systems.

Skills

Communication skills
Supervision
Data analysis
Problem-solving
Technology proficiency

Education

Bachelor's degree in nursing
Registered Nurse in California

Tools

Epic
Prior Authorizations
DOFRs
MCG

Job description

The University of California San Diego is looking for a Manager of Utilization Management. In this role, you will supervise Nurse Case Managers and Referral Coordinators ensuring compliance with regulations. You'll be responsible for overseeing department operations, analyzing data, and coaching team members.

The ideal candidate should possess a Bachelor's degree in nursing, be a Registered Nurse in California, with at least five years of relevant experience. The position offers a hybrid work schedule with the option to work in the office 1-2 days per week following orientation.

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