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RN / Registered Nurse / California / Permanent / Utilization Management Supervisor

Company: Central California Alliance for Health
Location: Merced
Posted on: February 10, 2020

Job Description:

Utilization Management Supervisor - Concurrent Review (RN)Merced, CAWe have an opportunity to join the Alliance as a Utilization Management Supervisor - Concurrent Review (RN), leading Concurrent Review staff in the Utilization Management department. WHAT YOU'LL BE RESPONSIBLE FORSupervising the Concurrent Review function, acting as a subject matter expert and providing guidance on Concurrent Review processes and functions. You will also be responsible for supervising, training and mentoring assigned staff and performing duties as a UM Concurrent Review Nurse, as needed. THE IDEAL CANDIDATEWork experience in a managed care environmentWork experience in Utilization Management leading a teamSome knowledge of healthcare regulatory processesWHAT YOU'LL NEED TO BE SUCCESSFULKnowledge of:The principles and practices of clinical nursingThe principles and practices of UMThe basic principles and practices of supervision and trainingMedi-Cal and related policy and Title 22 regulations'Some knowledge of Milliman Care GuidelinesAbility to:Train, mentor, supervise and evaluate the work of staff, promote an atmosphere of teamwork and cooperation, and motivate staff to achieve goals and objectivesPlan, organize and prioritize the work of others, delegate effectively, coordinate activities and projects, follow up on work assignments and adhere to timelinesExercise good judgment and tact in relating to contracting health care providers and beneficiariesProvide leadership, facilitate meetings and guide employees in the resolution of issueEducation and Experience:Current unrestricted license as a Registered Nurse issued by the State of CaliforniaAssociates degree in Nursing and a minimum of five years of clinical nursing experience which included at least one year of Utilization Management experience and some supervisory or team lead experience years (or a Bachelors degree and a minimum of two years); or a combination of education and relevant work experience may be qualifyingOUR BENEFITSMedical, Dental and Vision PlansAmple Paid Time Off11 Paid Holidays per year401(a) Retirement Plan457 Deferred Compensation PlanRobust Health and Wellness ProgramEV Charging StationsAnd many more ( a complete position description and to apply online, please visit our careers website at ( USWe are a group of over 500 dedicated employees, committed to our mission of providing accessible, quality health care that is guided by local innovation. We feel that our work is bigger than ourselves. We leave work each day knowing that we made a difference in the community around us.Join us at Central California Alliance for Health (the Alliance), where you will be part of a culture that is respectful, diverse, professional and fun, and where you are empowered to do your best work. As a regional non-profit health plan, we serve approximately 340,000 members in Santa Cruz, Monterey and Merced counties. To learn more about us, click here ( or check out this video ( At this time the Alliance does not provide any type of sponsorship. Applicants must be currently authorized to work in the United States on a full-time, ongoing basis without current or future needs for sponsorship.

Keywords: Central California Alliance for Health, Merced , RN / Registered Nurse / California / Permanent / Utilization Management Supervisor , Executive , Merced, California

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