The Manager of Medical Management is responsible for the overall day-to-day operations of the staff and activities requiring clinical licensure in the Utilization Management (UM) department. This position will work closely leaders to develop and organize the department’s work priorities and deliverables. This position will manage clinical personnel to orchestrate and oversee the completion of tasks requiring clinical determinations.

Oversees and monitors operational compliance with organizational standards, policies and procedures and regulatory requirements. Develops and implements approved departmental policies and procedures/workflows. Implements and monitors departmental performance standards.  Performs ongoing monitoring and evaluation of departmental operations to assure optimal efficiency and effectiveness.

Qualifications

• Education Required: Bachelor's Degree in Nursing.
• At least 6-8 years of clinical nursing experience with at least 3-5 years of supervisory/management experience. 
• Minimum 3 years of relevant health plan experience.
• Experience with Medi-Cal, under-served and culturally diverse populations.  
• Experience with state Medi-Cal regulations. 
• Audit/oversight experience.
• Licenses/Certifications RequiredRegistered Nurse (RN) - Active, current and unrestricted California License

About the Hospital

As the nation's largest publicly-operated health plan, we have a great responsibility to the communities we serve, and our employees play an essential role in ensuring we meet those needs.

Why Join Us?
Opportunity. Amazing co-workers. A supportive management team. Great compensation and benefits. Camaraderie and a true sense of mission. If you want a career that truly contributes to the good of all, join us as we work towards a healthier L.A.