RN Utilization Manager (Hybrid)

About the role

We’re hiring an RN Referrals Manager/Utilization Manager to lead a high-volume referrals department. This is a newly established leadership role supporting referral processing, regulatory compliance, and performance management, with 11 direct reports plus offshore referral coordinators. Located in Palm Springs, CA.

Responsibilities

• Provide daily oversight of the Referral Department (workflow, quality, turnaround times)
• Ensure compliance with applicable regulatory and health plan requirements
• Coach, train, and develop staff; monitor productivity and performance trends
• Support audits (CMS/DMHC/DHCS/Health Plan) and corrective action plans
• Serve as the clinical resource for referral processing and peer-to-peer coordination
• Partner with medical leadership and senior directors to improve processes and documentation

Requirements

• Active California RN license
• Bachelor’s Degree in Nursing (BSN) required (Master’s preferred)
• 3+ years RN experience in Utilization Review/Compliance Review/Acute Care/ER
• 3+ years in a Supervisory/Managerial role
• Strong knowledge of clinical criteria and documentation standards; familiarity with diagnosis/procedure coding practices

Benefits

• Medical insurance at no cost to employee (employer covered)
• No-cost pharmacy benefit (employee)
• Dental, Vision, EAP, Life/AD&D, LTD options
• 401(k) with company match; PTO (released after 90-day evaluation)
• Referral bonus: earn up to $500 per referral (no limit on number of referrals)

Pay

$123,968 per year

Schedule

Monday–Friday, 8 AM–5 PM