Utilization Management Nurse
$74.16 - $107.75 per hourUCLA Health
General Information Press space or enter keys to toggle section visibility
Work Location: Los Angeles, CA, USA Onsite or Remote
Fully On-Site
Work Schedule
Monday-Friday 8am-4:30pm
Posted Date
05/15/2026
Salary Range : $74.16 - 107.75 Hourly
Employment Type
4 - Staff: Limited
Duration
6 months
Job #
30315
Primary Duties and Responsibilities Press space or enter keys to toggle section visibility
The Utilization Management (UM) Nurse supports appropriate level-of-care determination, patient flow, and revenue cycle integrity across inpatient, partial hospitalization, and intensive outpatient programs. The UM Nurse functions in two utilization management roles for coverage purposes utilization review/payor authorization and patient placement-ensuring continuity of operations, timely access to care, and optimal bed utilization. Key Responsibilities include:
As a condition of employment, the final candidate who accepts an 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; or have filed an appeal of a finding of substantiated misconduct with a previous employer. Current/former UC employees are subject to a personnel file review.
Work Location: Los Angeles, CA, USA Onsite or Remote
Fully On-Site
Work Schedule
Monday-Friday 8am-4:30pm
Posted Date
05/15/2026
Salary Range : $74.16 - 107.75 Hourly
Employment Type
4 - Staff: Limited
Duration
6 months
Job #
30315
Primary Duties and Responsibilities Press space or enter keys to toggle section visibility
The Utilization Management (UM) Nurse supports appropriate level-of-care determination, patient flow, and revenue cycle integrity across inpatient, partial hospitalization, and intensive outpatient programs. The UM Nurse functions in two utilization management roles for coverage purposes utilization review/payor authorization and patient placement-ensuring continuity of operations, timely access to care, and optimal bed utilization. Key Responsibilities include:
- Performs initial, concurrent, and continued-stay utilization reviews to obtain and maintain third-party payor authorization.
- Communicates clinical information to support medical necessity determinations and continued-stay approvals.
- Serves as a liaison between payors and the interdisciplinary treatment team regarding authorization and level-of-care requirements.
- Tracks authorizations, follows up on denials, and supports appeal processes as needed.
- Collaborates with financial counseling and revenue cycle teams to support accurate reimbursement.
- Performs patient placement responsibilities as part of utilization management coverage.
- Assesses clinical acuity, level-of-care needs, and bed availability to support timely admissions and transfers.
- Monitors census and capacity to optimize bed utilization and patient flow.
- Completes required documentation accurately and timely in the electronic health record.
- Participates in quality improvement initiatives related to utilization management and patient flow.
- BSN or MSN, required
- 5 years of psychiatric nursing care experience required.
- Current valid CA RN license, required
- BLS from the ARC or AHA, required.
- Prior case management experience, highly desired
- Proficient in Microsoft Office
As a condition of employment, the final candidate who accepts an 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; or have filed an appeal of a finding of substantiated misconduct with a previous employer. Current/former UC employees are subject to a personnel file review.
Vacancy posted 17 hours ago
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