Utilization Management Supervisor – Referrals

Community Health Group; Chula Vista (CA); On-site; USD 70,000 - 83,000; Full time

Job summary

Community Health Group in Chula Vista, CA is seeking a full-time Referral and Authorization Supervisor to enhance timely processing of referrals across inpatient and ambulatory services. The role supports clinical staff and coordinates with facilities and providers to ensure smooth transitions of care.

Responsibilities include supervising referral workflows, maintaining census data, and ensuring compliance with state and federal regulations. Strong communication and leadership are essential.

Qualifications

• Excellent written and verbal communication skills.
• Demonstrated leadership abilities in a team setting.
• Experience overseeing referral and authorization in a managed care environment.
• Strong analytical and data interpretation skills.
• Working knowledge of Medi-Cal, DHCS, CMS, CCS, DMHC.
• Understanding of HIPAA, Privacy Act, and ERISA.

Responsibilities

• Supervises staff to ensure referrals processed within timelines.
• Oversees inpatient support services and bed census communications.
• Provides customer services to facilities, providers, and members.
• Reports on care delivery issues and utilization patterns.
• Facilitates referral turnaround by processing admission/ referral data.

Skills

Communication skills

Leadership

Analytical skills

Referral/authorization oversight

HIPAA/compliance knowledge

Policy and procedure knowledge

Education

Associate degree or equivalent in managed care

BA in medical field preferred

Job description

Community Health Group in Chula Vista, CA is seeking a full-time Referral and Authorization Supervisor to enhance timely processing of referrals across inpatient and ambulatory services. The role supports clinical staff and coordinates with facilities and providers to ensure smooth transitions of care.

Responsibilities include supervising referral workflows, maintaining census data, and ensuring compliance with state and federal regulations. Strong communication and leadership are essential.