UCLA Health

Utilization Management Assistant Director - RN

UCLA Health • $116K — $264K *
Los Angeles, CA 90011In-Person
Healthcare
Less than 5 years of experience
5 days ago
Job Overview by Ladders

Qualifications

  • 5-7 years of experience in case management or utilization management roles
  • Proven leadership skills with experience supervising multidisciplinary teams
  • Strong understanding of CMS and NCQA compliance standards
  • Experience with high-risk and specialty patient populations
  • Excellent interpersonal and communication skills
  • Ability to analyze and monitor clinical performance metrics

Responsibilities

  • Lead ICM and UM programs daily, ensuring quality oversight
  • Supervise and mentor a team of healthcare professionals
  • Manage care coordination for complex patient groups
  • Execute transitions of care and discharge planning initiatives
  • Ensure adherence to quality and compliance standards
  • Track operational performance metrics to improve patient outcomes
  • Collaborate with various healthcare stakeholders for seamless transitions

Benefits

  • Comprehensive health insurance options
  • Generous paid time off and holiday schedule
  • Professional development and training opportunities
  • Supportive work environment focused on team collaboration
  • Opportunities for community involvement and outreach programs
Full Job Description
Description

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

About UCLA Health

UCLA Health is a world-renowned academic medical center located in Los Angeles, California. It comprises four hospitals, including Ronald Reagan UCLA Medical Center, and more than 200 primary and specialty care clinics. UCLA Health is affiliated with the David Geffen School of Medicine at UCLA and is consistently ranked among the top hospitals in the United States. The health system employs over 20,000 people and serves as a major center for patient care, medical education, and research.
Learn more about UCLA Health
Industry
Healthcare
* Ladders Estimates

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