RN Utilization Management Manager — Hybrid Leader

University of California San Diego; San Diego (CA); Hybrid; USD 132,600 - 259,800; Full time

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.