What are the responsibilities and job description for the Utilization Management Assistant Director - RN position at UCLA Health Careers?
Description
Join a world-class healthcare organization and play a key leadership role in delivering high-quality, patient-centered care. UCLA Health is seeking a dynamic and experienced Utilization Management Assistant Director to oversee Intensive Case Management (ICM) and Utilization Management (UM) operations focused on high-risk and complex patient populations.
In this leadership role, you will supervise a multidisciplinary team supporting patients across the continuum of care while driving operational excellence, regulatory compliance, and improved patient outcomes. This is an exciting opportunity for a collaborative healthcare leader passionate about care coordination, utilization management, and value-based care.
Key Responsibilities
- 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
Salary Range: $116,300 - $264,600/Annually
Salary : $119,700 - $272,700