Utilization MGT Supervisor - Utilization Management - Days - FT - Orange

University of California, Irvine; Orange (CA); On-site; USD 100,000 - 130,000; Full time

Job summary

UCI Health is seeking a Supervisor, Utilization Management to provide frontline supervision and operational oversight across multiple hospitals within the system. The role ensures consistent use of evidence-based medical necessity criteria and regulatory compliance while guiding a team of utilization management professionals.

The ideal candidate will bring strong leadership, RN licensure in California, and a track record in case management, collaborating with physicians and interdisciplinary

Qualifications

• Current California RN license
• Bachelor of Science in Nursing required
• 3+ years of Case Management or equivalent experience

Responsibilities

• Supervise frontline utilization management staff across assigned area
• Coordinate daily workflow, staffing assignments, and productivity metrics
• Ensure adherence to evidence-based medical necessity criteria and regulatory requirements
• Collaborate with physicians, case managers, and interdisciplinary teams to optimize patient outcomes

Skills

Leadership

Communication

Customer service

Multitasking

Interdisciplinary collaboration

Education

BSN (Bachelor of Science in Nursing)

Bachelor's degree in relevant field

Job description

Who We Are

UCI Health is one of California's largest academic health systems and the clinical enterprise of the University of California, Irvine. Established on July 1, 1976, UCI Health has grown into a 1,461-bed health system that includes UCI Health - Orange, UCI Health - Irvine, four Community Network hospitals and a growing network of ambulatory care centers across Orange and Los Angeles counties. As Orange County’s only academic health systems, UCI Health is home to the only National Cancer Institute-designated comprehensive cancer center based in the county, the region’s only American College of Surgeons-verified Level I adult and Level II pediatric trauma center, American College of Emergency Physicians Gold Level 1 Geriatric Emergency Department and a nationally recognized regional burn center verified by the American Burn Association. Powered by UC Irvine, UCI Health serves 5.6 million people across Orange County, western Riverside County and southeast Los Angeles County through excellence in patient care, research and medical education.

Your Role on the Team

Position Summary

The Supervisor, Utilization Management is responsible for the direct frontline supervision, daily workflow coordination, and operational oversight of utilization management coworkers within the assigned area across multiple hospitals within the UCI Health system. The incumbent assists in aligning utilization management competencies and metrics, supporting the standardization and execution of utilization management operations within a centralized model to ensure consistent application of evidence-based medical necessity criteria, regulatory compliance, and organizational best practices. This role oversees daily workflow distribution, staffing assignments, productivity, quality, and performance metrics, ensuring timely completion of admission reviews, continued stay reviews, status determinations, and other utilization management activities by all assigned coworkers. The Supervisor is accountable for the selection, onboarding, competency validation, performance evaluation, and professional development of utilization management coworkers, serving as a clinical resource and mentor while fostering a culture of continuous improvement and operational excellence. The incumbent collaborates with physicians, Physician Advisors, Case Management, Revenue Cycle, Patient Access, Clinical Documentation Integrity, Social Work, Bed Management, and other interdisciplinary teams to advance utilization management objectives and support optimal patient outcomes. This position models professional leadership, accountability, and excellent customer service, exercising independent judgment in managing day-to-day utilization management operations and operating with limited oversight.

What It Takes to be Successful

Required Qualifications

• Must possess the skill, knowledge, and ability essential to the successful performance of assigned duties
• Must possess complete understanding of acuity levels for specific patient population
• Must demonstrate customer service skills appropriate to the job
• Must be willing to work a flexible schedule, including weekends, and on call after hours as needed
• Minimum 3 years of Case Management experience
• Familiarity of Joint Commission, CMS, CDPH and CCS requirements
• Excellent written and verbal communication skills in English
• Demonstrated leadership, interpersonal skills, and ability to communicate with varied levels of customer audiences
• Demonstrated leadership skills/experience
• Demonstrated experience and ability to build effective working relationships and to represent the department effectively in order to accomplish goals
• Current California RN license
• Computer literacy and proficiency
• Bachelors’ degree in relevant field or the equivalent combination of education and experience
• All external candidates must have a Bachelor of Science in Nursing
• Ability to manage multiple concurrent projects and maintain a work pace appropriate to the workload
• Ability to facilitate and lead interdisciplinary rounds
• Ability to establish and maintain effective working relationships across the Health System

Preferred Qualifications

• Knowledge of University policies and procedures
• CCM, ACM or Case Management credentialing
• Bilingual skills

Licenses and Certifications

• Registered Nurse

Total Rewards

We offer a wealth of benefits to make working at UCI even more rewarding. These benefits may include medical insurance, sick and vacation time, retirement savings plans, and access to a number of discounts and perks. Please utilize the links listed here to learn more about our compensation practices and benefits.

Conditions of Employment

The University of California, Irvine (UCI) seeks to provide a safe and healthy environment for the entire UCI community. As part of this commitment, all applicants who accept an offer of employment must comply with the following conditions of employment:

• Background Check and Live Scan
• Employment Misconduct*
• Legal Right to Work in the United States
• Vaccination Policies
• Smoking and Tobacco Policy
• Drug Free Environment

*Misconduct Disclosure Requirement: As a condition of employment, the final candidate who accepts a conditional offer of employment will be required to disclose if they have been subject to any final administrative or judicial decisions within the last seven years determining that they committed any misconduct; received notice of any allegations or are currently the subject of any administrative or disciplinary proceedings involving misconduct; have left a position after receiving notice of allegations or while under investigation in an administrative or disciplinary proceeding involving misconduct; or have filed an appeal of a finding of misconduct with a previous employer.

The following additional conditions may apply, some of which are dependent upon business unit or job specific requirements.

• California Child Abuse and Neglect Reporting Act
• E-Verify
• Pre-Placement Health Evaluation

Details of each policy may be reviewed by visiting the following page: https://hr.uci.edu/new-hire/conditions-of-employment.php

Closing Statement

The University of California is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age, protected veteran status, or other protected categories covered by the UC Anti-Discrimination Policy. We are committed to attracting and retaining a diverse workforce along with honoring unique experiences, perspectives, and identities. Together, our community strives to create and maintain working and learning environments that are inclusive, equitable, and welcoming. UCI provides reasonable accommodations for applicants with disabilities upon request. For more information, please contact UCI's Employee Experience Center (EEC) at [e-mail] or at [phone], Monday - Friday from 8:30 a.m. - 5:00 p.m.

Consideration for Work Authorization Sponsorship

Must be able to provide proof of work authorization