RN Utilization Management Supervisor — Lead Prior Auth & Care

Jemma LLC; California; On-site; USD 99,000 - 131,000; Full time

Benefits offered by this job

Health insurance

PTO & holidays

401K match

Advancement opportunities

Job summary

WelbeHealth in California seeks an experienced Utilization Management RN Supervisor to lead the daily UM operations and ensure timely, compliant care for participants.

You will review prior-authorization requests, mentor staff, and collaborate with providers to resolve utilization issues while advancing team competency and performance. This full-time role offers a competitive salary within the stated range and a comprehensive benefits package.

Qualifications

• Minimum of three (3) years of relevant clinical nursing experience.
• Strong preference for prior PACE experience.
• Two (2) years of supervisory experience with demonstrated aptitude to mentor and develop team members.

Responsibilities

• Direct oversight of day-to-day operations within the designated UM team.
• Assist the team in reviewing prior-authorization requests for medical necessity and appropriateness.
• Identify, develop, and provide orientation and competency development for staff processing and/or reviewing authorizations.

Skills

Nursing

Supervisory experience

Job description

WelbeHealth in California seeks an experienced Utilization Management RN Supervisor to lead the daily UM operations and ensure timely, compliant care for participants.

You will review prior-authorization requests, mentor staff, and collaborate with providers to resolve utilization issues while advancing team competency and performance. This full-time role offers a competitive salary within the stated range and a comprehensive benefits package.