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RN Utilization Management Lead

Martin Luther King, Jr. Community Hospital

Whittier, CA
3 days ago
$90k - $110k

Job Description

Join Martin Luther King, Jr. Community Hospital as an RN Utilization Management Lead, where you'll oversee the utilization management team to ensure quality patient care and compliance with clinical guidelines. This role offers the opportunity to lead process improvements and mentor staff in a collaborative healthcare environment.

Key Responsibilities

  • Oversee daily operations of the utilization management team
  • Ensure timely and compliant reviews for medical necessity and prior authorizations
  • Collaborate with medical directors and care teams
  • Mentor staff and monitor workflow
  • Participate in quality improvement initiatives

Required Qualifications

  • Associates Degree in Nursing or equivalent
  • Current California Registered Nurse License
  • Minimum 5 years recent experience in Case Management or Utilization Management or Prior Authorization
  • Experience in MCG and/or Interqual

Preferred Qualifications

  • BSN
  • Certification in UM or CM
  • Bilingual language skills (Spanish)
  • CCM Certification

Benefits & Perks