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.
Key Responsibilities:
- Lead and manage UM programs to align with organizational goals for quality, efficiency, and compliance.
- Collaborate closely with clinical UM, Care Management, Quality, Information Technology (IT), and other key stakeholders, to streamline authorization workflows and improve operational efficiency
- Develop and implement strategies to reduce avoidable denials and enhance patient throughput
- Ensure adherence to regulatory and accreditation standards through Effective program oversight and compliance monitoring
- Coordinate complex, multi work stream initiatives that involve cross functional teams
- Utilize data analytics to inform decision making, identify opportunities for improvement, and measure program outcomes
- Standardize UM processes, tools, and documentation to promote consistency and scalability
- Facilitate communication and change management efforts to support successful program adoption and sustainability
- Support other clinical departments as needed to advance organizational objectives
Required:
- Bachelor’s degree in healthcare administration, business, public health, or a related field and/or equivalent experience
- 5+ years of related experience or training in healthcare operations, utilization management, care management, quality, revenue cycle, contracting, or related operational/program work
- 3+ years of experience leading cross functional projects or programs that include workflow improvement, stakeholder coordination, and measurable outcomes (may be included within the 5+ years)
- Strong analytical skills to define metrics, interpret trends, and translate findings into action plans
- Ability to communicate clearly in writing and verbally with clinicians, administrators, and technical partners
- Facilitate work groups and meetings effectively including agendas, decision capture, and follow up tracking
- Uses sound judgment to prioritize work, manage competing deadlines and raise risks early
- Ability to build collaborative relationships across departments and supports constructive resolution of workflow issues
- Designs scalable workflows, documentation, and controls that support consistent operations and sustainment
- Maintains discretion and protects sensitive information learned through work activities
- Master’s degree (MPH, MHA, MSN, MBA) or equivalent advanced training
- Demonstrates working knowledge of UM workflows such as prior authorization, concurrent review, and denials/appeal.
- Uses UM tools and reporting methods (e.g. InterQual/MCG, authorization platforms, self-service reporting) to support outcomes
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
