Utilization Management Supervisor, Non-Clinical

University of California - Los Angeles Health; Los Angeles (CA); Sur place; USD 73 000 - 150 000; Plein temps

Résumé du poste

University of California is seeking a Utilization Management Supervisor (Non-Clinical) to oversee daily operations of non-clinical patient navigation services for high-risk and high-utilizer populations within the Utilization Management Department in Los Angeles. You will supervise a team of coordinators, navigators, and nurses to ensure efficient workflows and high-quality service delivery.

The role requires multi-year experience in managed care and strong leadership, with oversight of care

Qualifications

• High school diploma, GED or equivalent experience.
• Four or more years of experience in a Managed Care Case Management and care coordination environment - REQUIRED
• Three or more years of experience in Inpatient and ambulatory Managed Care program/referrals - REQUIRED
• Three or more years of leadership or Supervisory role - REQUIRED
• Two or more years of experience supporting Intensive Case Management, Utilization Management, Skilled Nursing Facility, and Home Health programs
• Familiarity with Medicare Advantage and value-based care models
• Experience with electronic health records (e.g., Epic/CareConnect)
• Four years or more experience in Managed care Organization, Medical Group operations, Health Plan administration and workflows.

Responsabilités

• Supervise and lead Patient Navigators and Coordinators across UM, SNF, ED follow-up, and Home Health workflows.
• Oversee patient navigation activities including scheduling, transportation coordination, DME coordination, and referrals.
• Monitor work queues, referrals, discharge tracking, and care transitions for timely follow-up.
• Support effective transitions of care through post-discharge outreach and appointment adherence.
• Collaborate with interdisciplinary teams to address barriers to care and support patient engagement.
• Manage staff scheduling, attendance, payroll/timekeeping, training and development.
• Analyze data to support quality improvement, compliance, and strategic decisions.
• Lead process improvements and optimize departmental workflows and policies.

Connaissances

Leadership

Communication

Multitasking

Project management

Data analysis

Teamwork

Interpersonal skills

Detail-oriented

Formation

High School Diploma or equivalent

Outils

Epic/CareConnect

Excel

Visio

PowerPoint

Word

Description du poste

Description

Under the direction of the Utilization Management Assistant Director, the Utilization Management Supervisor (Non-Clinical) oversees the daily operations of non-clinical patient navigation services supporting high-risk and high-utilizer patient populations within the Utilization Management Department. This role supervises a team of coordinators, patient navigators and concurrent nurses, ensuring efficient workflow management, timely access to care, effective care transitions, and high-quality service delivery.

Key Responsibilities

• Supervise and provide leadership to Patient Navigators and Coordinators supporting UM, SNF, ED follow-up, and Home Health workflows.
• Oversee patient navigation activities, including appointment scheduling, transportation coordination, DME coordination, and community resource referrals.
• Monitor operational work queues, referrals, discharge tracking, and care transition activities to ensure timely follow-up and service delivery.
• Support effective transitions of care through post-discharge outreach, appointment adherence, and coordination of services.
• Collaborate with interdisciplinary teams to identify and address barriers to care and support patient engagement initiatives.
• Manage staff performance, scheduling, attendance, payroll/timekeeping, training, and professional development.
• Analyze operational and utilization data to support quality improvement, compliance, and strategic decision‑making.
• Lead process improvement initiatives and support the development and optimization of departmental workflows, policies, and procedures.
• Support system‑related functions and operational activities related to care coordination, authorizations, and utilization management workflows.

Salary Range: $73,000 - $149,600/Annually

Qualifications

• High school diploma, GED or equivalent experience.
• Four or more years of experience in a Managed Care Case Management and care coordination environment - REQUIRED
• Three or more years of experience in Inpatient and ambulatory Managed Care program/referrals - REQUIRED
• Three or more years of leadership or Supervisory role - REQUIRED
• Two or more years of
  • Experience supporting Intensive Case Management, Utilization Management, Skilled Nursing Facility, and Home Health programs
  • Familiarity with Medicare Advantage and value-based care models
  • Experience with electronic health records (e.g., Epic/CareConnect)
• Four years or more experience in Managed care Organization, Medical Group operations, Health Plan administration and workflows.
• Ability to multi-task, work with frequent interruptions, and meet deadlines. Must be detailed, oriented, attentive, organized, and able to follow directions.
• Proficient computer skills including working knowledge of Microsoft Excel, Visio, Power P and Word.
• Ability to operate a wide variety of office equipment, including computers, printers, copy machines, facsimile receiver/transmitter, scanners and mailing equipment.
• Ability to communicate thoughts and information clearly and succinctly in writing as well as verbally.
• Highly organized, reliable, consistently seeking learning opportunities and new challenges, High EQ, communication skills, problem solving ability, and teamwork, humble yet confident, peers feel comfortable requesting your assistance.
• Experience in Medicare Advantage or value-based care models - Preferred