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Kaiser Permanente
Los Angeles, CA, United States
Kaiser Permanente Manager Utilization Management Woodland Hills , California Apply Now 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 O
Job Source: Kaiser PermanenteProvidence
Mission Hills
**Description** Under the direction of the Utilization Supervisor/ Manager, this position is responsible for the distribution, review, accurate and timely processing of SJHH patient referrals requested from providers. Providence caregivers are not simply valued – they’re invaluable. Join our team at Providence Medical Foundation and thrive in our c
Job Source: ProvidenceNorth American Staffing Group
Montebello
Job Description Job Description Medica Talent Group is excited to share this temporary opportunity! We partnered with a prominent healthcare organization based in Montebello, CA to fill a UM Coordinator position. Please consider applying if you come with a minimum of 2 years of Utilization Management and Prior Authorization experience. Job Detail
Job Source: North American Staffing GroupAltaMed Health Services Corporation
Montebello, CA, United States
Work Boldly. Live Brilliantly. At AltaMed, we don't just serve our communities, we are part of them. We have raised the expectations of what a community clinic can deliver because we think quality care is for everyone. And, we are determined to provide it no matter the challenges because this is more than a job. It's the calling of our lives and it
Job Source: AltaMed Health Services CorporationWelbeHealth
Los Angeles
Job Description Job Description At 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 a
Job Source: WelbeHealthSherman Oaks Hospital
Los Angeles, CA, United States
Overview: At Sherman Oaks Hospital, our dedicated team of professionals are committed to our core values of quality, compassion, and community. As a member of the Prime Healthcare Foundation, Sherman Oaks Hospital is actively seeking new members to join its award-winning team! Sherman Oaks Hospital is a 153-bed, not-for-profit, acute-care communit
Job Source: Sherman Oaks HospitalAstrana Health
Monterey Park, CA, United States
Job Title: Utilization Management Coordinator Department: Health Services - UM About 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
Job Source: Astrana HealthUniversity of California - Los Angeles Health
Los Angeles, CA, United States
Description 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. In this key position, you will be the primary point of contact for receiving and resolving member denials. You will review de
Job Source: University of California - Los Angeles HealthLos Angeles, CA, United States
Description Take 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 leader within our Medicare Advantage team, you will be responsible for assisting with the day-to-day management of the UM department and coordinators. This will involve coordinating staff schedules to efficiently handle incoming referrals and phone call volume. You will develop workflows, desktop procedures, forms, training materials, and protocols for achieving team objectives and key performance indicators. You will hire and train non-clinical coordinator staff as well as manage and monitor their production and quality performance. This position involves researching and resolving simple and complex patient/provider issues related to the authorization and claims process. You will also conduct performance evaluations, counsel employees, and take disciplinary action as necessary.
Salary Range: 61,400 - 121,400 Annually
Note: This posted position is 1 of 2 positions available for hire. All applicants will apply through this requisition and if selected will be hired into one of the available positions. Qualifications We're seeking a self-motivated, team-focused, deadline-driven, detail-oriented leader with:
* High school diploma, GED or equivalent required
* Two or more years of experience managing staff in a healthcare environment
* Two or more years of managed care or health plan experience preferred
* Experience processing ambulatory commercial, Medicare Fee for Service, and Medicare Advantage prior authorizations desired
* Knowledge of the HMO referral process, eligibility verification, and health plan benefit interpretation a plus
* Excellent critical thinking, organizational, and problem-resolution skills required
* Ability to work effectively across functional areas of the company.
* Computer proficiency with Microsoft Excel and Word
* Ability to multi-task and work with frequent interruptions
* Strong communication skills
* Ability to work well with ambiguity and stressful situations
* Ability to maintain confidentiality of patient and business records
UCLA Health is a world-renowned health system with four award-winning hospitals and more than 260 community clinics throughout Southern California. We're also home to the world-class medical research and clinical education capabilities of the David Geffen School of Medicine. Through the efforts of our outstanding people, we have become Los Angeles' trusted provider of exceptional, compassionate patient care. If you're looking to experience greater challenge and fulfillment in your career, you can at UCLA Health.
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Utilization Management Supervisor jobs in Los Angeles, CA, United States
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