Utilization Management Manager — Nursing Leader, Hybrid

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

Job summary

The University of California - San Diego Medical Centers is seeking a Manager of Utilization Management to oversee Nurse Case Manager and Referral Coordinator staff. This role ensures compliance with managed care regulations and coordinates department operations. Candidates must have a Bachelor's degree in nursing and a California RN license, along with at least five years of relevant experience.

The position involves supervising staff, optimizing workflows, and collecting data on utilization management processes, ensuring adequate training and support for new team members.

Qualifications

• Bachelor's degree in nursing required.
• Minimum of five years of relevant experience required.
• Strong experience with prior authorization review process.

Responsibilities

• Oversee day-to-day department operations.
• Coordinate case management teams for evaluations.
• Collect and report data on UM processes.

Skills

Communication skills

Supervisory skills

Prior authorization review

Technology proficiency

Education

Bachelor's degree in nursing

Registered Nurse in California

Tools

MCG

Epic

Job description

The University of California - San Diego Medical Centers is seeking a Manager of Utilization Management to oversee Nurse Case Manager and Referral Coordinator staff. This role ensures compliance with managed care regulations and coordinates department operations. Candidates must have a Bachelor's degree in nursing and a California RN license, along with at least five years of relevant experience.

The position involves supervising staff, optimizing workflows, and collecting data on utilization management processes, ensuring adequate training and support for new team members.