Director, Clinical Utilization Management

WeShare Health; Orange (CA); On-site; USD 100,000 - 140,000; Full time

Benefits offered by this job

Health, life, dental, and vision insurance

403(b) with company match

Innovative work culture

Job summary

WeShare Health in California is searching for a Utilization Management Director to establish and lead the internal clinical utilization management function. This role will encompass building structures, policies, and teams for efficient healthcare review processes. Ideal candidates are licensed clinical professionals with extensive utilization management experience. The opportunity offers competitive salary and benefits while making a meaningful impact in affordable healthcare solutions.

Qualifications

• Active, unrestricted Registered Nurse license or other applicable clinical license required.
• 7+ years of healthcare experience, including significant experience in utilization management.
• 5+ years of leadership experience managing clinical staff.

Responsibilities

• Develop and launch UHSM’s internal Utilization Management and Clinical Operations function.
• Inform design and implementation of a Salesforce‑based clinical case management platform.
• Oversee the review of requested healthcare services.

Skills

Utilization management

Healthcare operations

Clinical review

Leadership

Analytical skills

Education

Bachelor’s degree in Nursing, Healthcare Administration, or related field

Job description

WeShare Health in California is searching for a Utilization Management Director to establish and lead the internal clinical utilization management function. This role will encompass building structures, policies, and teams for efficient healthcare review processes. Ideal candidates are licensed clinical professionals with extensive utilization management experience. The opportunity offers competitive salary and benefits while making a meaningful impact in affordable healthcare solutions.