Utilization Management RN
WelbeHealth•Los Angeles, CA
•$99,310 - $131,089
About The Position
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 and our Utilization Management team ensures we can provide timely, quality, compliant, and cost-effective care to our participants. By guiding this team, the Utilization Management RN Supervisor drives the continuous improvement of our care delivery processes.
Requirements
- Minimum of three (3) years of relevant clinical nursing experience
- Two (2) years of supervisory experience with demonstrated aptitude to mentor and develop team members
Nice To Haves
- Strong preference for prior PACE experience
Responsibilities
- Direct oversight of day-to-day operations within the designated UM team
- Assist the team in reviewing prior-authorization requests for medical necessity and appropriateness
- Identify, develop, and provide orientation and competency development for staff processing and/or reviewing authorizations
- Collaborate with providers (internal and external), clinical staff, and others to timely resolve any utilization management issues
Benefits
- Medical insurance coverage (Medical, Dental, Vision)
- 17 days of personal time off (PTO)
- 12 holidays observed annually
- Sick time
- 401K savings + match
- Advancement opportunities
- Base salary plus bonus
- Comprehensive healthcare coverage
- Broad range of additional benefits
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What This Job Offers
Job Type
Full-time
Career Level
Manager
Education Level
No Education Listed
