Utilization Management Assistant Director – RN
Veterans in Healthcare · Los Angeles, CA · 1 mo ago
Healthcare$116k–$265k/yrFull-time
Description
Utilization Management Assistant Director – RN
Work Location
Los Angeles,CA
Job #
30668
Work Hours
Monday – Friday, 8:00am – 5:00pm PST; schedule may vary including weekends and holidays
Employment Type
2 – Staff- Career
Duration
indefinite
Salary Range
$116300-264600 Annually
Posted Date
May 29, 2026
Bargaining Unit
99
JOB DUTIES
- Provide day-to-day leadership and oversight of Intensive Case Management (ICM) and Utilization Management (UM) programs
- Supervise and mentor a multidisciplinary team including Registered Nurses, Social Workers, and care coordination staff
- Oversee care coordination activities for high-risk, high-utilizer, oncology, Medicare Advantage, and specialty patient populations
- Lead transitions of care, discharge planning, readmission prevention, and emergency department tracking initiatives
- Ensure compliance with CMS, NCQA, and organizational policies related to utilization management and case management
- Monitor operational and clinical performance metrics including readmission rates, ED utilization, and length of stay
- Conduct staff coaching, onboarding, training, and performance evaluations
- Collaborate with physicians, hospital leadership, post-acute providers, and community agencies to ensure seamless patient care transitions
- Support utilization review activities for hospital, rehabilitation, skilled nursing, and home health settings
- Partner with revenue cycle and appeals teams to support denial prevention and medical necessity documentation
- Drive process improvement initiatives focused on quality outcomes, patient experience, and cost-effective care delivery
- Promote patient-centered, culturally competent, and holistic care across all care settings
JOB QUALIFICATIONS
- Experience in healthcare administration, preferably in a hospital setting
- Registered Nurse (RN) license required
- Strong leadership and supervisory skills
- Excellent communication and interpersonal skills
- Knowledge of healthcare regulations and policies
- Ability to manage multiple tasks and priorities
- Proficiency in Microsoft Office Suite
Awards & recognition
- MONICA - Blessed to touch many lives through serving; uplifts other employees with words of encouragement and a smile
- SOZIT - Welcoming and friendly team; supportive management
- EDGAR - Growth potential and training offered