Manager, Utilization Management

4 weeks ago

Corona, United States Optum Full time

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us to start **Caring. Connecting. Growing together.**

Optum’s Pacific West region is redefining health care with a focus on health equity, affordability, quality, and convenience. From California, to Oregon and Washington, we are focused on helping more than 2.5 million patients live healthier lives and helping the health system work better for everyone. At Optum Pacific West, we care. We care for our team members, our patients, and our communities. Join our culture of caring and make a positive and lasting impact on health care for millions.
- **This position allows for local hybrid/telecommute options for local California residents**

**Primary Responsibilities**:

- Sets team direction, resolves problems and provides guidance to members of the team
- Adapts departmental plans and priorities to address business and operational challenges
- Ensures staff coverage to meet compliance and leverage current resources to meet business needs
- Addresses escalations and communicates critical issues up the chain
- Assists with fulfillment of compliance requirements. Collaborates with department director on audits and policies. Cascades regulatory requirements to UM team. Supports director with committee presentations
- Supports enterprise-wide initiatives and process changes
- Collaborates with various functional area stakeholders to implement or enhance new or existing processes. Directs UM team on successful and timely execution of initiatives (i.e. plan, create resources, training, communications, assess)
- Communicates changes and monitors overall process
- Develops and builds a high performing team. Ensures individual accountability and demonstration of core values, attendance, quality, productivity. Ensures team meets established performance metrics
- Models and encourages solution-based and critical thinking mindset amongst the team

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

**Required Qualifications**:

- Current, unrestricted RN or LVN license in California
- 3+ years of experience as a utilization management (prior authorization review) nurse
- 2+ years of experience in a leadership role

**Preferred **Qualifications**:

- BSN degree
- Experience in managed care
- At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, _location_ and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized _groups_ and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering _equitable_ care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission_._
- Diversity creates a healthier atmosphere: _OptumCare_ is an Equal Employment Opportunity/Affirmative Action employers and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law_._
- _

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