Nurse Manager

4 days ago


Los Angeles, California, United States Necnic Group, LLC Full time
Nurse Manager - Utilization Management

At Necnic Group, LLC, we are seeking a skilled Nurse Manager to lead our Utilization Management Program. As a key member of our team, you will be responsible for ensuring cost-effective and quality patient care by optimizing resource utilization.

Key Responsibilities:
  • Develop and maintain policies and procedures for Utilization Management, ensuring compliance with regulatory agencies and internal standards.
  • Collaborate with multidisciplinary teams to plan and coordinate care across the continuum, identifying risk management and quality of care issues.
  • Manage member care with hospital facilities and providers, ensuring appropriate utilization of resources and meeting Health Plan guidelines.
  • Provide direction to staff on utilization review, care coordination, discharge planning, and other services, ensuring seamless care transitions.
  • Conduct statistical studies on utilization trends, patterns, and outcomes, informing data-driven decisions.
  • Lead and develop a team of professionals and clerical support staff, fostering a culture of excellence and continuous improvement.
Requirements:
  • Minimum three years of experience in utilization management and discharge planning in an acute care setting, with supervisory or management experience.
  • BSN or bachelor's degree in a healthcare-related field, such as management or health services administration.
  • Registered Nurse License (California) and Certified Case Manager certification a plus.
What We Offer:
  • Competitive compensation ranging from $165,000 - $175,000.
  • Comprehensive benefits package.


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