- 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
- Collaborate with providers (internal and external), clinical staff, and others to timely resolve any utilization management issues
- 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
- Medical insurance coverage (Medical, Dental, Vision) starting day one of employment
- Work/life balance – we mean it 17 days of personal time off (PTO), 12 holidays observed annually, sick time
- Advancement opportunities - We've got a track record of hiring and promoting from within, meaning you can create your own path
- And additional benefits
-
Utilization Manager
3 weeks ago
APLA Health Los Angeles, United StatesJob Details · Job Location · Baldwin Hills - Offices - Los Angeles, CA · Salary Range · $80, $106,345.36 Salary/year · Description · POSITION SUMMARY: · This position is responsible for the management of the daily operations of Utilization Management (UM) at APLA Health and ...
-
Utility Account Manager
1 week ago
Insight Global Los Angeles, United StatesTitle: Gas & Electric Utility Client Account Manager · Location: Los Angeles, CA or San Diego, CA (Hybrid) · Salary: $150-$200K · Qualifications: · Bachelor of Science, Engineering, or related technical field. · Minimum 8+ years of related experience, including 4-5 years of direc ...
-
LVN Utilization Manager
1 week ago
Clinica Romero Los Angeles, United StatesJob Description · Job DescriptionSalary: · Position Title: LVN Utilization Manager · Department: Medical · Position reports to: Director of Nursing · Position Summary: · The LVN Utilization Manager ensures that health care services are administered with quality, cost efficienc ...
-
Utilization Management Nurse, Senior
1 week ago
Blue Shield of California Los Angeles, United States Full timeYour Role · The Utilization Management team reviews the inpatient stays for our members and correctly applies the guidelines for nationally recognized levels of care. The Utilization Management Nurse will report to the Utilization Management Nurse Manager. In this role you will ...
-
Utilization Management Nurse, Senior
2 weeks ago
Blue Shield of California Los Angeles, United States Full timeYour Role · The Commercial Post Service Review team is responsible for clinically reviewing claims that are the result of either a preservice or claim denial. The Commercial Post Service Review RN will report to the Manager, Post Service. In this role you will perform accurate a ...
-
Senior Utilization Management Assistant
2 weeks ago
Providence Los Angeles, United States Full timeUnder the supervision of Regional Director of Care Management, the Utilization Management Coordinator is responsible for providing support to the Care Management team who coordinates care. This position works closely as a healthcare team member and performs complex tasks related ...
-
Utilization Management Supervisor
8 hours ago
University of California Los Angeles, United StatesTake on an important leadership role within an award-winning health system. Help improve patient experiences and operational efficiency as part of a world-class healthcare team. Take your career in an exciting new direction. You can do all this and more at UCLA Health. · As a key ...
-
Supervisor - Case Manager/Utilization Review
3 weeks ago
Pyramid Consulting, Inc Los Angeles, United StatesImmediate need for a talented Supervisor - Case Manager/Utilization Review. This is a 03+ Months Contract opportunity with long-term potential and is located in Los Angeles, CA(Onsite). Please review the job description below and contact me ASAP if you are interested. · Job ID: ...
-
Manager Utilization Management
3 weeks ago
Kaiser Permanente Los Angeles, United States Full timeJob Summary: · Manages the day-to-day operations of the Utilization Management Program in the Service Area or a Medical Center. Ensures cost effective and quality patient care by appropriate utilization of resources. Provides direction to staff which may include Outside Utilizat ...
-
Manager Utilization Management
1 week ago
Kaiser Permanente Los Angeles, United StatesManages the day-to-day operations of the Utilization Management Program in the Service Area or a Medical Center. Ensures cost effective and quality patient care by appropriate utilization of resources. Provides direction to staff which may include Outside Utilization, Extended Ca ...
-
Supervisor, Utilization Management RN
2 days ago
North American Staffing Group, Inc. Los Angeles, United StatesJob Description · Job DescriptionTitle: Supervisor, UM RN · Term: Direct-Hire, full time · Location: Fully Remote (Company located in Los Angeles, CA.) · Requirements: · Bachelor's degree in nursing. · Active License · CCM Certification · Advanced Certification in Excel software ...
-
RN Supervisor, Utilization Management
2 weeks ago
North American Staffing Group Los Angeles, United StatesJob Description · Job DescriptionMedica Talent Group is excited to share this Direct Hire opportunity with you · We are looking foran experienced RN Supervisor, Utilization Management seeking a permanent opportunity. Our client offers growth and an exciting workplace to join alon ...
-
Supervisor, Utilization Management RN
4 days ago
L.A. Care Health Plan Los Angeles, United StatesPress Tab to Move to Skip to Content Link · Select how often (in days) to receive an alert: · Job Category: · Clinical · Location: · Los Angeles, CA, US, 90017 · Position Type: · Full Time · Requisition ID: · 10949 · Salary Range: · $102, Min.) - $132, Mid.) - $163, Max.) · ...
-
UCLA Health Los Angeles, United StatesProvide key clinical support within a world-class health organization. Help ensure the delivery of exceptional, compassionate, and appropriate patient care. Take your professional expertise to the next level. You can do all this and more at UCLA Health. · Under the direction and ...
-
Utilization Management Coordinator
2 weeks ago
360 Behavioral Health Los Angeles, United StatesJob Category · : · Z&S Management Chatsworth Support Center · Requisition Number · : · UTILI002763 · Apply now · Posted : April 26, 2024 · Full-Time · Locations · Showing 1 location · Van Nuys, CA 91406, USA · Description · Who are we? · At 360 Behavioral Health, we take p ...
-
utilization management denial review nurse
4 weeks ago
UCLA Health Los Angeles AFB, CA , USA, United StatesGeneral Information · Press space or enter keys to toggle section visibility · Work Location: Los Angeles, USA · Onsite or Remote · Flexible Hybrid · Work Schedule · Monday - Friday, 8:00am - 5:00pm PST · Posted Date · 03/26/2024 · Salary Range: $ Annually · Employment Type · 2 - ...
-
360 Behavioral Health Los Angeles, United StatesUtilization Management Coordinator- Temporary Assignment · Job Category · : · Z&S Management Chatsworth Support Center · Requisition Number · : · UTILI002753 · Apply now · Posted : April 23, 2024 · Full-Time · Locations · Showing 1 location · Van Nuys, CA 91406, USA · Desc ...
-
Utilization Management Denial Review Nurse
4 days ago
UCLA Health Los Angeles, United States· Take on a high-impact role within a world-class health organization. Help drive the continued delivery of exceptional patient care. Take your career to the next level. You can do all this and more at UCLA Health. · You will play a key part in promoting high-quality, cost-effec ...
-
LVN Utilization Manager
2 weeks ago
Clinica Romero Los Angeles, United StatesJob Description · Job DescriptionSalary: $66,560 - $80,000 · Position Title: LVN Utilization Manager · Department: Medical · Position reports to: Director of Nursing · Position Summary: · The LVN Utilization Manager ensures that health care services are administered with qualit ...
-
Utilization Management Coordinator
1 week ago
ApolloMed Monterey Park, United StatesAbout the Role · : The Utilization Management Coordinator is responsible for supporting clinical, management, and client activities, comprising the UM Program. The Utilization Management Coordinator understands all UM processes such as pre-authorizations, retro reviews, Division ...
Utilization Management RN - Los Angeles, United States - WelbeHealth
![Default job background](https://contents.bebee.com/public/img/bg-user-ex-1.jpg)
Description
Job Description
Job DescriptionAt WelbeHealth, we are transforming the reality of senior care by providing an all-inclusive healthcare option to the most vulnerable senior population, functioning as both a care provider and care plan to those individuals we serve.
Our Health Plan Services team plays a critical role in our participant's journey and our Utilization Management team ensures we can provide timely, quality, compliant, and cost-effective care to our participants. By guiding this team, the Utilization Management RN Supervisor drives the continuous improvement of our care delivery processes.
Essential Job Duties:
Job Requirements:
Benefits of Working at WelbeHealth: Apply your clinical expertise in meaningful ways as we rapidly expand. You will have the opportunity to design the way we work in the context of an encouraging and loving environment where every person feels uniquely cared for.
Salary/Wage base range for this role is $ $57.29 hourly + Bonus + Equity. WelbeHealth offers competitive total rewards package that includes, 401k match, healthcare coverage and a broad range of other benefits. Actual pay will be adjusted based on experience and other qualifications.
Compensation$47.74—$57.29 USDCOVID-19 Vaccination Policy
At WelbeHealth, our mission is to unlock the full potential of our vulnerable seniors. In this spirit, please note that we have a vaccination policy for all our employees and proof of vaccination, or a vaccine declination form will be required prior to employment. WelbeHealth maintains required infection control and PPE standards and has requirements relevant to all team members regarding vaccinations.
Our Commitment to Diversity, Equity and Inclusion
At WelbeHealth, we embrace and cherish the diversity of our team members, and we're committed to building a culture of inclusion and belonging. We're proud to be an equal opportunity employer. People seeking employment at WelbeHealth are considered without regard to race, color, religion, sex, gender, gender identity, gender expression, sexual orientation, marital or veteran status, age, national origin, ancestry, citizenship, physical or mental disability, medical condition, genetic information or characteristics (or those of a family member), pregnancy or other status protected by applicable law.
Beware of Scams
Please ensure your application is being submitted through a WelbeHealth sponsored site only. Our emails will come from email addresses. You will never be asked to purchase your own employment equipment. You can report suspected scam activity to