Make a difference in people’s lives every day. When you join UCLA Health, you’ll be working at an institution that provides leading-edge care to the people of L.A. and throughout the world. We provide our team members with the environment and support to do amazing work, because each and every one of them plays a vital role in our commitment to care.
Take on a vital role within a leading health organization. Help ensure smooth and efficient case management processes to support quality care. Take your expertise to the next level. You can do all this and more at UCLA Health.
Under the direction of the Utilization Management, Assistant Director, you will play a key role in processing and managing authorization requests and care coordination support. You will:
- Receive urgent, routine, pre-service, and retro authorization requests
- Process referrals and authorizations following established procedures within the medical group utilization department
- Prepare and process referrals according to Delegation of Financial Responsibility (DOFR), UCLA Medical Group Medical Guidelines, and health plan contracts
- Identify and prepare necessary documents for the next level of review
- Maintain and prepare specific reports and manage computer applications and logs
- Conduct urgent care coordination needs for complex and high risk population
- Care managed, monitor, coordinate needs of members/patients followed by Case Management
- Work directly with a nurse, ICM team lead and Medical Director.
- Review pending claims for approval or denial
- High school diploma, GED, or equivalent experience
- Experience working in a Managed Care environment, highly desired
- Experience processing ambulatory managed care referrals, preferred
- Proficient computer skills with working knowledge of Microsoft Excel and Word
- Ability to operate a variety of office equipment, including computers, printers, copiers, fax machines, scanners, and mailing equipment
- Ability to multi-task, work with frequent interruptions, and meet deadlines
- Strong attention to detail, organization, and ability to follow directions
- Clear and concise communication skills, both written and verbal
- Familiarity with Vodavi phone system
- Ability to lift up to 25 pounds
- Willing to work on the following schedule: Wednesday through Friday 1:00pm -10:00pm and Saturday, Sundays and Holidays from 8:00am – 5:00pm
EMPLOYMENT SCAM ALERT:
UCLA Health Recruitment is currently being targeted by scam artists through external job board sites. Review some tips in order to avoid becoming targeted. El reclutamiento de salud de UCLA actualmente está siendo atacado por estafadores a través de sitios de juntas de trabajo externos. Revisar algunos consejos para evitar ser apuntado.
“The environment is nurturing and fosters growth. When I come to work, I know what I'm doing matters.”
VINCENT, Sr. CLS Specialist, Toxicology
MONICA
I've been blessed to touch so many lives through my serving. It's a privilege to uplift other employees with words of encouragement and a smile.
SOZIT
The first thing i noticed when i joined the team was how everyone is very welcoming and friendly with supportive management. I did not feel like an outsider.
EDGAR
Once I joined, I knew UCLA Health was THE place to be due to the growth potential and training offered
RENE
If you want to grow professionally, this is the right place for you.
ERA
We are family here. We support each other. We collect together.
ELIZABETH
It’s so diverse and inclusive here. There’s always the opportunity to share your thoughts. It's a place where you feel you belong.
JERRY
Your career path at UCLA Health will enable you to follow a myriad of avenues and turns. It opens up a wide variety of opportunities.
ORLANDO
There’s a togetherness and higher level of commitment to teamwork at UCLA Health. We are several groups and teams that work together with a common goal which is to improve our patients experience.
DAVID
UCLA Health walks the walk and talks the talk! It's an incredible feeling to work for an organization that always puts the patient first. I am honored to work in full alignment with the UCLA Health Mission and Vision.
DR. ISLA GARRAWAY
UCLA has incredible resources and a team science approach. The ability to work with collaborative teams and access the amazing resources around campus is the best part about being at UCLA.
RADU
UCLA is very diverse in its personnel as well as its many research fields studied
JENNA
UCLA Health provides so many opportunities to exchange ideas, share moments and grow. I have learned a lot about team management and relationship building.
SHARON
I was looking for a job to further my career and continue to improve and learn as a therapist.
TARO
I have been blessed to be surrounded by supportive colleagues who aspire me to be the best version of myself.
Awards & recognition
