Utilization MGT Supervisor - Utilization Management - Days - FT - Orange

About the role

The Supervisor, Utilization Management oversees the direct frontline supervision, daily workflow coordination, and operational oversight of utilization management coworkers within the assigned area across multiple hospitals within the UCI Health system. This role supports the standardization and execution of utilization management operations, ensuring consistent application of evidence-based medical necessity criteria, regulatory compliance, and organizational best practices.

Responsibilities

• Aligns utilization management competencies and metrics
• Supports standardization and execution of utilization management operations
• Ensures timely completion of admission reviews, continued stay reviews, status determinations, and other utilization management activities by all assigned coworkers
• Selects, onboards, validates competency, evaluates performance, and develops professional development for utilization management coworkers
• Facilitates interdisciplinary rounds and establishes effective working relationships with various departments
• Collaborates with physicians, Physician Advisors, Case Management, Revenue Cycle, Patient Access, Clinical Documentation Integrity, Social Work, Bed Management, and other interdisciplinary teams to advance utilization management objectives and support optimal patient outcomes
• Models professional leadership, accountability, and excellent customer service

Requirements

• Complete understanding of acuity levels for specific patient populations
• Customer service skills appropriate to the job
• Willingness to work a flexible schedule, including weekends, and on-call after hours as needed
• Minimum 3 years of Case Management experience
• Familiarity with Joint Commission, CMS, CDPH, and CCS requirements
• Excellent written and verbal communication skills in English
• Demonstrated leadership, interpersonal skills, and ability to communicate with varied levels of customer audiences
• Demonstrated leadership skills/experience
• Demonstrated experience and ability to build effective working relationships and represent the department effectively
• Bachelor’s degree in relevant field or the equivalent combination of education and experience
• Ability to manage multiple concurrent projects and maintain a work pace appropriate to the workload
• Computer literacy and proficiency

Qualifications

• Current California RN license
• Knowledge of University policies and procedures
• CCM, ACM, or Case Management credentialing preferred
• Bilingual skills preferred

Skills

• Leadership
• Interpersonal skills
• Communication

Benefits

UCI offers a comprehensive benefits package to make working at UCI even more rewarding. These benefits may include medical insurance, sick and vacation time, retirement savings plans, and access to a number of discounts and perks. For more information, please visit this page.

Conditions of Employment

• Background Check and Live Scan
• Employment Misconduct
• Legal Right to Work in the United States
• Vaccination Policies
• Smoking and Tobacco Policy
• Drug Free Environment
• Misconduct Disclosure Requirement