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.
- 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
- Current unrestricted RN licensure in CA required
- Bachelors of Science, Nursing (BSN) degree required
- Experience Minimum 5–7 years of clinical experience, with at least 3 years in case management or utilization management
- Minimum 3-5 years in a leadership or supervisory role
- Experience in Managed Care Organization, Medical Group or Health Plan
- Strong knowledge of CMS guidelines, utilization management, and care coordination
- Ability to multi-task, work with frequent interruptions, and meet deadlines. Must be detailed, oriented, attentive, organized, and able to follow directions.
- Proficient computer skills including working knowledge of Microsoft Excel, Visio, Power P and Word.
- Ability to operate a wide variety of office equipment, including computers, printers, copy machines, facsimile receiver/transmitter, scanners and mailing equipment.
- Ability to communicate thoughts and information clearly and succinctly in writing as well as verbally.
- Highly organized, reliable, consistently seeking learning opportunities and new challenges, High EQ, communication skills, problem solving ability, and teamwork, humble yet confident, peers feel comfortable requesting your assistance.
- Experience in Medicare Advantage or value-based care models
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.
KATHERINE
UCLA Health is a supportive, collaborative, and purposeful environment where leadership is invested in your growth and creating real opportunities. And knowing that what we do matters gives a real sense of purpose.
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
