Utilization Management Manager, Medicare Advantage - RN
$112.9k - $256.9kUCLA Outpatient Clinics
Overview 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. As a Manager for Medicare Advantage Utilization Management, you’ll provide direct management to a team of UM coordinators and nurses. You’ll work closely with Medicare Advantage leadership to plan, execute, and manage various initiatives related to UM administrative, operational, and strategic objectives. You’ll demonstrate leadership and effective communication by fostering collaborative relationships with peers, co-workers, and staff. You’ll be responsible for overseeing and coordinating the following major functions: Pre-service Authorizations/Denial Letters Concurrent Review Continuity of Care Retro Claims Retrospective Review Referral Automation Business Rules/Configuration Salary Range: $112,900 - $256,900 Annually #J-18808-Ljbffr UCLA Outpatient Clinics
$116.3k - $264.6k
...exceptional patient care. Take your career to the next level. You can do all this and more at UCLA Health. As a Manager for Medicare Advantage Utilization Management, you’ll provide direct management to a team of UM coordinators and nurses. You’ll work closely with Medicare...Suggested- A leading health organization in Los Angeles is seeking a Manager for Medicare Advantage Utilization Management. This role involves overseeing a team of coordinators and nurses to ensure high-quality patient care and managing strategic initiatives. The ideal candidate...Suggested
- Ocean State Job Lot is seeking an RN for Utilization Management in Los Angeles, CA. This role involves coordinating care submissions and documentation for patient admissions, focusing on high-quality care and efficiency. Candidates must hold an Associate's Degree in Nursing...Suggested
- The University of California - Los Angeles Health is looking for a dynamic Utilization Management Assistant Director to supervise Intensive Case Management and Utilization Management operations. This role involves leading a multidisciplinary team to improve patient outcomes...Suggested
$116.3k - $264.6k
Yourcommission is seeking a Utilization Management Assistant Director in Los Angeles to lead Intensive Case Management and Utilization Management... ...improving patient outcomes. Ideal candidates possess a BSN, active RN license in CA, and experience in management roles within...Suggested$116.3k - $264.6k
UCLA Health is seeking an experienced Utilization Management Assistant Director to oversee Intensive Case Management and Utilization Management operations... ...operational excellence. The ideal candidate will have a BSN, RN licensure in California, and significant experience in case...$47.58 - $76.68 per hour
...requirements and policies. The role demands a current California R.N. license and preferably a BSN, alongside experience in utilization and quality management. Compensation ranges from $47.58 to $76.68 hourly, reflecting the expertise required for this role. #J-18808-Ljbffr...Hourly pay- Veterans in Healthcare is seeking a Utilization Management Assistant Director - RN in Los Angeles, CA. This role entails overseeing Intensive Case Management and Utilization Management programs, mentoring a multidisciplinary team, and ensuring compliance with healthcare...
- Air Combat Effectiveness Consulting Group, LLC in Monterey Park is seeking a Case Manager RN or LVN to join our Utilization Review Department. This per diem position involves coordinating care for patients, conducting admissions, and liaising with health plans to ensure...Daily paid
$47.2 - $63.45 per hour
...service! Responsibilities Responsible for the quality and resource management of all patients that are admitted to the facility from the point... ...Of Social Work for Licensed Clinical Social Worker. However, RN Case Manager preferred. 3. Five years acute care nursing experience...Full timePart timeWork experience placementLocal areaShift work- ...leading health organization based in Los Angeles seeks a Manager for Medicare Advantage Utilization Management. The role involves managing a team to drive... ...concurrent reviews. Candidates should possess a valid CA RN license, a BSN, and extensive experience in utilization...
- ...assigned nursing and ancillary personnel utilizing both professional and supervisory discretion... ...: Registered Nurse (RN) licensure in the state of practice: Required... ...in collaboration with staff members and management with minimal incidents of absence or unbalanced...Full timeWork experience placementShift workDay shift
- ...implementation, revision and reporting of the case management program. Acts as a liaison between the... ...: Registered Nurse (RN) licensure in the state of practice: Required... ..., the appropriateness of resource utilization, consultations, treatment plan, estimated...Full timeWork experience placementWork at officeDay shift
$56.12 - $84.75 per hour
...Description Care Manager RN at Providence Saint Joseph Medical Center in Burbank, CA. This position is Full-time and will work... ...~2 years experience in Case Management (Care Coordination or Utilization Management) or successful completion of the Transitions in Practice...Minimum wageFull timeContract workLocal areaShift workDay shift$57.28 - $88.92 per hour
...Description The Inpatient Registered Nurse (RN) Care Manager provides professional, comprehensive, patient centric care management... ...include assessment and planning, coordination of care, resource utilization management and/ or review, discharge planning, documentation...Minimum wageFull timeLocal areaShift work- ...Nurse Manager Manages the day-to-day operations of the Utilization Management Program in the Service Area or a Medical Center. Ensures cost effective and quality... ...and healthcare management; TJC, Title XXII, Medicare, MediCal and other local, state, and federal regulations...Local area
- ...RN Case Manager Qualifications for RN Case Manager: The Case Manager is responsible for managing a continuum of care from admission... ...for assigned patients. Partners with medical staff, utilizes scientific evidence for best practices, relevant data and compliance...Temporary workShift work
- ...Job Title : Registered Nurse (RN) Disease Manager Job Overview : The Registered Nurse (RN) Disease Manager is responsible for coordinating... ...patient outcomes and document interactions accurately. Utilize health information technology to document care, track...Remote work
$2,065.88 - $2,160.88 per month
...Contract - W2 Case Management/Utilization Review Registered Nurse (RN) Job Location: Los Angeles, California Start Date: June 1, 2026 Profession: Registered Nurse (RN) Facility: Estimated Pay: $2065.88 - $2160.88 Duration:13 weeks Specialty...Hourly payWeekly payContract workShift work- ...and previous illness(es). Provides professional nursing care by utilizing all elements of nursing process. Assesses and evaluates patient... ...self-sufficiency and optional comfort care. Acts as Case Manager when assigned by Clinical Supervisor and assumes responsibility...Monday to Friday
$77.18 - $82.69 per hour
...Description Case Manager RN at Providence St. Joseph Medical Center in Burbank, CA. This position is Per Diem and will work 8-hour... ...~2 years Experience in Case Management (Care Coordination or Utilization Management) or successful completion of the Transitions in...Daily paidMinimum wageContract workShift workDay shift- ...Summary: Uniti Med is looking for a Registered Nurse (RN) in Los Angeles, California. This assignment lasts 1... ...Referral bonus up to $700 Registered Nurse (RN),Case Management/Utilization Review, About the Company: Uniti Med is an award-...Hourly payWeekly payTemporary workImmediate start
- ...implementation, revision and reporting of the case management program. Acts as a liaison between the... ...: Registered Nurse (RN) licensure in the state of practice: Required... ..., the appropriateness of resource utilization, consultations, treatment plan, estimated...Full timeWork experience placementWork at officeDay shift
$7,000 per month
...Inpatient Case Manager This position offers a sign on bonus! $10k for RN & $7k for LVN The Inpatient Case Manager is responsible for the assessment, treatment... ...for the patient's current severity of illness, utilizing the appropriate tests and diagnostics, in the...Hourly payFull timeCasual workWork at officeImmediate startRelocation packageFlexible hours$78.39k - $97.99k
...drives us forward every day. Job Overview The Supervisor, Utilization Management - Clinical position is responsible for overseeing and... ...license issued by the State of California, Vocational Nursing. RN, preferred AA degree or equivalent work experience preferred...Work experience placementFlexible hours$65.53 - $84.75 per hour
...developing and implementing individualized care plans utilizing evidence-based tools for risk stratification to... ...for current UCLA Health Nursing staff) CA RN License and BLS certification Recent experience in case management, utilization management and discharge planning...Hourly payRemote workDay shift$111.2k - $185.2k
...Acute Dialysis Services Program Manager - RN page is loaded## Acute Dialysis Services Program Manager - RNremote type: Onsitelocations:... ...inpatient staff. Responsible for high volume monthly treatments. Utilizes the FMC mission, core values and customer service philosophy...Temporary workWork experience placementWorldwideRelocation packageNight shiftWeekend work$65.53 - $84.75 per hour
...developing and implementing individualized care plans utilizing evidence-based tools for risk stratification to... ...for current UCLA Health Nursing staff) CA RN License and BLS certification Recent experience in case management, utilization management and discharge planning...- Position Summary The Manager of Care Management will supervise and direct all levels of the Care Management team that includes RN Care Managers, Lead Care Management RN, Care Management... ...patient care or care coordination, utilization, case/disease management experience a...
$135k - $145k
...mission to serve more markets. About This Role As our Enrollment RN Manager, you’ll be the clinical leader at the front door of our PACE... ..., and celebrate your achievements. Plan for Your Future Take advantage of our 401(k) plan with an employer match—because your future...Temporary workPart timeWork at officeLocal areaRemote workMonday to FridayFlexible hours
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Utilization Management Manager, Medicare Advantage - RN. Be the first to apply!
- apple localization manager Los Angeles, CA
- compounding manager Los Angeles, CA
- nicu manager Los Angeles, CA
- ca identity manager Los Angeles, CA
- mitigation manager Los Angeles, CA
- senior compensation manager Los Angeles, CA
- manager total rewards Los Angeles, CA
- manager salesforce Los Angeles, CA
- valuation manager Los Angeles, CA
- fraud prevention manager Los Angeles, CA

