Supervisor – Inpatient Case Management (SD/OC))

Astrana Health, Inc.•Orange, CA

2d•$110,000 - $120,000•Hybrid

About The Position

The Supervisor, Inpatient Case Management is responsible for leading and overseeing the daily operations of the inpatient case management team in the San Diego market. This role ensures timely, compliant, and high-quality utilization management, care coordination, and documentation while serving as a clinical and operational resource to staff, providers, and Medical Directors. The Supervisor plays a key role in driving consistency, productivity, and alignment with Astrana Health policies, payer requirements, and regulatory standards.

Requirements

Active, unrestricted RN license (required)
Minimum 3–5 years of inpatient case management or utilization management experience
Strong working knowledge of medical necessity criteria, benefit guidelines, and payer requirements
Experience collaborating with physicians, hospitalists, and Medical Directors
Ability to interpret clinical documentation and apply appropriate level-of-care determinations
Strong organizational, communication, and problem-solving skills
Comfortable managing performance, productivity, and quality metrics
Proficient with case management systems and electronic medical records
Ability to work in a fast-paced, high-accountability environment

Nice To Haves

Prior supervisory or lead experience strongly preferred

Responsibilities

Provide day-to-day supervision, coaching, and support to inpatient case managers
Ensure timely completion of utilization review, authorizations, and documentation in accordance with policy and payer requirements
Monitor team productivity, quality, and compliance with established workflows and turnaround times
Serve as a clinical resource for complex cases, transfers, denials, and medical necessity reviews
Collaborate daily with Medical Directors, hospitalists, and facility partners regarding bed days, level of care, and skilled admissions
Escalate and help resolve barriers to care, discharge delays, and provider issues
Support auditing, reporting, and continuous improvement initiatives related to quality and performance
Assist with onboarding, training, and development of inpatient case management staff
Ensure appropriate use of benefit guidelines, contracted providers, and payer rules
Promote a culture of accountability, teamwork, and high-quality member care
Miscellaneous responsibilities as directed by leadership