Job Duties

• Perform day-to-day oversight and management of the Utilization Management Nurse team for their daily activities, productivity, quality and accuracy and time-off requests, etc.

• Report to Customer’s department leadership.

• Participate in department meetings, training and audit activities equal to Customer’s employees. 

Role/Education Requirements

• Active California RN License

• Minimum of 2 years of recent health plan experience 

• Demonstrated capabilities in managing multiple clinical teams, both remote and onsite

• High level of expertise in UM services 

• Experience with MediCal and LA County procedures and policies (preferred but not required)

• Experience with MCG Criteria (preferred but not required)
  

Role Details

• Job Type: Contract

• Pacific business hours, Monday through Friday

• Evenings, weekends or holiday coverage, as needed

• Work Location: Remote