Clinical Nurse Supervisor , Utilization Management DCU

Regal Medical Group; Los Angeles (CA); On-site; USD 99,000 - 121,000; Full time

Benefits offered by this job

Health insurance

401(k)

Paid vacation

Job summary

A leading healthcare organization in Los Angeles seeks a Nurse Clinical Supervisor to oversee the denial process within the utilization management department. The role includes supervising unit staff, collaborating on denial decisions with medical professionals, and ensuring compliance with regulatory standards. The position offers a competitive starting salary of $110,000, depending on experience, along with a sign-on bonus and comprehensive benefits such as employer-paid health coverage and 401(k) plans.

Qualifications

• Must have experience in utilization management and supervision.
• Knowledge of regulatory and compliance standards is essential.
• Strong leadership and interpersonal skills required.

Responsibilities

• Supervise denial unit staff and manage work assignments.
• Collaborate with medical directors for denial decisions.
• Conduct internal quality audits and prepare departmental reports.
• Monitor daily operations related to productivity and compliance.

Skills

Leadership

Compliance Management

Quality Audits

Staff Training

Job description

Overview

The Nurse Clinical Supervisor, UM Denial Compliance oversees the denial process within the utilization management (UM) department, ensuring that all denials are handled efficiently, accurately, and in full compliance with regulatory, accreditation, and health plan requirements. The role involves both leadership and compliance management functions.

Key Responsibilities

• Supervise licensed and non-licensed denial unit staff, including work assignments, evaluations, and discipline.
• Collaborate with medical directors, physician reviewers, and other UM/PA teams to coordinate denial decisions.
• Maintain compliance with privacy and regulatory standards.
• Prepare and manage departmental reports, audits, and work plans.
• Conduct internal quality audits for the denial process.
• Develop and deliver staff education and training related to compliant denial correspondence.
• Monitor daily operations—such as productivity, turnaround times, and staffing.
• Stay current on state and federal regulations and implement necessary process adjustments.
• Lead process improvement and compliance initiatives aligned with company objectives.
• Serve as a resource for clinical and technical guidance across teams.

Expected Pay

The pay range for this position at commencement of employment is expected to start at $110,000 year dependent on licensure and experience; however, base pay offered may vary depending on multiple individualized factors, including market location, job-related knowledge, licensure, skills, and experience. This position also offers a sign on bonus.

Sign on bonus differs based on medical license LVN $7,000 or RN $10,000.

Benefits

• Health and wellness:
• Employer-paid medical, dental, and pharmacy coverage
• Vision, FSAs, EAP, and Behavioral Health services.
• Retirement and savings:
• 401(k) and income protection.
• Work-life balance: Vacation, sick time, paid holidays, company celebrations, and a business-casual environment.

Company Culture

The organization emphasizes growth, teamwork, and advancement, offering a fast-paced but supportive environment where employee success contributes directly to company success.

The Employer will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of the LA City Fair Chance Initiative for Hiring Ordinance.