Your Role on the Team

Position Summary:
The Supervisor, Utilization Management is responsible for 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. The incumbent assists in aligning utilization management competencies and metrics, supporting the standardization and execution of utilization management operations within a centralized model to ensure consistent application of evidence-based medical necessity criteria, regulatory compliance, and organizational best practices. This role oversees daily workflow distribution, staffing assignments, productivity, quality, and performance metrics, ensuring timely completion of admission reviews, continued stay reviews, status determinations, and other utilization management activities by all assigned coworkers. The Supervisor is accountable for the selection, onboarding, competency validation, performance evaluation, and professional development of utilization management coworkers, serving as a clinical resource and mentor while fostering a culture of continuous improvement and operational excellence. The incumbent 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. This position models professional leadership, accountability, and excellent customer service, exercising independent judgment in managing day-to-day utilization management operations and operating with limited oversight.

What It Takes to be Successful

Required Qualifications:

Must possess the skill, knowledge, and ability essential to the successful performance of assigned duties

Must possess complete understanding of acuity levels for specific patient population

Must demonstrate customer service skills appropriate to the job

Must be willing to work a flexible schedule, including weekends, and on call after hours as needed

Minimum 3 years of Case Management experience

Familiarity of 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 to represent the department effectively in order to accomplish goals

Current California RN license

Computer literacy and proficiency

Bachelors' degree in relevant field or the equivalent combination of education and experience

All external candidates must have a Bachelor of Science in Nursing

Ability to manage multiple concurrent projects and maintain a work pace appropriate to the workload

Ability to facilitate and lead interdisciplinary rounds

Ability to establish and maintain effective working relationships across the Health System

Preferred Qualifications:

Knowledge of University policies and procedures

CCM, ACM or Case Management credentialing

Bilingual skills

Licenses and Certifications:

Registered Nurse

Education:

Total Rewards

We offer a wealth of benefits 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. Please utilize the links listed here to learn more about our compensation practices and benefits.

Conditions of Employment:

The University of California, Irvine (UCI) seeks to provide a safe and healthy environment for the entire UCI community. As part of this commitment, all applicants who accept an offer of employment must comply with the following 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: As a condition of employment, the final candidate who accepts a conditional offer of employment will be required to disclose if they have been subject to any final administrative or judicial decisions within the last seven years determining that they committed any misconduct; received notice of any allegations or are currently the subject of any administrative or disciplinary proceedings involving misconduct; have left a position after receiving notice of allegations or while under investigation in an administrative or disciplinary proceeding involving misconduct; or have filed an appeal of a finding of misconduct with a previous employer.

The following additional conditions may apply, some of which are dependent upon business unit or job specific requirements.

• California Child Abuse and Neglect Reporting Act
• E-Verify
• Pre-Placement Health Evaluation

Details of each policy may be reviewed by visiting the following page: https://hr.uci.edu/new-hire/conditions-of-employment.php

Consideration for Work Authorization Sponsorship

Must be able to provide proof of work authorization