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Manager, Utilization Management Nurse Management

Blue Shield of California

Cypress, CA
2 days ago
$100k - $130k

Job Description

Join Blue Shield of California as a Manager in Utilization Management Nurse Management, where you'll lead a team to enhance operational efficiency and ensure high-quality patient care. Your expertise will directly impact care coordination and compliance in a dynamic healthcare environment.

Key Responsibilities

  • Establish operational objectives for the department
  • Develop and maintain FCR workflows, protocols, and policies
  • Monitor and evaluate the performance of the FCR team
  • Ensure high-quality, patient-centered care management
  • Collaborate with other business units to achieve performance goals

Required Qualifications

  • Current CA RN License
  • Bachelor of Science in Nursing or advanced degree
  • 7 years of relevant experience
  • 3 years of management experience

Preferred Qualifications

  • 3+ years in inpatient or managed care environment
  • Excellent communication, interpersonal, and negotiation skills
  • Knowledge of NCQA requirements
  • Ability to analyze data and create reports

Benefits & Perks