Utilization Management Director

2 days ago


Bakersfield, California, United States All's Well Full time
Job Summary

We are seeking a highly skilled and experienced Utilization Management Director to join our team at All's Well. As a key member of our healthcare operations team, you will be responsible for providing comprehensive oversight of the Utilization Review process under the Knox Keene license and Department of Health Care Services contract.

Key Responsibilities
  • Provide strategic leadership and direction to the Utilization Review team
  • Develop and implement effective utilization management strategies to ensure compliance with regulatory requirements
  • Collaborate with cross-functional teams to identify and address areas for process improvement
  • Develop and maintain relationships with key stakeholders, including healthcare providers and payers
  • Stay up-to-date with industry trends and regulatory changes, and implement changes as necessary
Requirements
  • Bachelor's degree in Nursing or other relevant healthcare field required; Master's degree preferred
  • Minimum of 4 years of management-level experience in Utilization Management in a managed care environment or healthcare industry
  • Minimum of 4 years' clinical experience in Utilization Review or Case Management in a Health Plan or similar payer/provider setting
  • Valid driver's license and proof of State required auto liability insurance
  • Bilingual (English/Spanish) preferred
What We Offer

We offer a competitive salary and benefits package, including major medical, dental, vision, 401k, and statutory sick pay where required. We are committed to working with and providing reasonable accommodations to individuals with disabilities.

We are an EEO/AA Employer/Vet/Disabled and participate in the E-Verify program in certain locations as required by law. We also consider qualified applicants regardless of criminal histories, consistent with legal requirements.



  • Bakersfield, California, United States Impresiv Health Full time

    Job Title: Director of Utilization ManagementAt Impresiv Health, we are seeking a highly skilled and experienced Director of Utilization Management to join our team. As a key member of our healthcare consulting team, you will be responsible for providing comprehensive oversight of the Utilization Review process and ensuring that our clients receive...


  • Bakersfield, California, United States All's Well Full time

    Medical Director Job OpportunityWe are seeking a highly skilled Medical Director to join our team at All's Well Healthcare Staffing. As a Medical Director, you will be responsible for leading our medical team and providing strategic direction for our healthcare services.Key Responsibilities:Lead and manage a team of medical professionals to deliver...


  • Bakersfield, California, United States Outback Steakhouse Matilda Management Full time

    About Outback Steakhouse / Matilda ManagementWe are a leading restaurant group, committed to delivering exceptional dining experiences to our customers. Our team is passionate about providing top-notch service and quality food, while maintaining a fun and respectful work environment.Job SummaryWe are seeking a highly motivated and detail-oriented Dish...


  • Bakersfield, California, United States Kern Medical Full time

    Job Title: Utilization Review Nurse - Case ManagementKern Medical is seeking a skilled Utilization Review Nurse - Case Management to join our team. As a Utilization Review Nurse - Case Management, you will play a critical role in ensuring the efficient use of hospital resources while providing high-quality patient care.Job Summary:The Utilization Review...


  • Bakersfield, California, United States Dignity Health Full time

    About the RoleThe Director of Utilization Management is a senior leadership position responsible for overseeing the day-to-day operations of the utilization management nursing teams at Dignity Health. This role is critical in ensuring the efficient and effective management of healthcare services, while maintaining high-quality patient care.Key...


  • Bakersfield, California, United States Dignity Health Full time

    About the RoleThe Director of Utilization Management is a senior leadership position responsible for overseeing the day-to-day operations of the utilization management nursing teams. This includes preservice utilization review, concurrent inpatient review, and retro claim review.Key ResponsibilitiesLead the utilization management nursing teams in the...


  • Bakersfield, California, United States UEI College Full time

    UEI College: A Leader in Post-Secondary Career EducationWe are a company that is dedicated to driving personal and community transformation by empowering students to make a positive and enduring life change. Our mission is to provide high-quality educational programs that prepare students for successful careers.Job SummaryWe are seeking an Associate Director...


  • Bakersfield, California, United States Kern Medical Full time

    Job SummaryKern Medical is seeking a highly skilled Utilization Review Nurse - Case Management to join our team. As a key member of our healthcare organization, you will play a critical role in ensuring the efficient use of hospital resources while providing exceptional patient care.Key ResponsibilitiesConduct thorough medical record reviews to determine the...


  • Bakersfield, California, United States InsideHigherEd Full time

    Job SummaryWe are seeking an experienced Associate Director of Enterprise Applications to join our team at InsideHigherEd. The successful candidate will be responsible for overseeing the planning, development, maintenance, integration, and enhancement of our Enterprise Resource Planning (ERP) systems.Key ResponsibilitiesProvide operational oversight for our...


  • Bakersfield, California, United States Universal Healthcare MSO LLC Full time

    Job SummaryWe are seeking a skilled UM Nurse Reviewer to join our team at Universal Healthcare MSO LLC. As a key member of our Utilization Management department, you will play a critical role in ensuring that our members receive high-quality, cost-effective care.Key ResponsibilitiesConduct timely reviews of pre-certification and concurrent requests, aligning...


  • Bakersfield, California, United States Healthcare Finance Direct LLC Full time

    EPIC Director of Software EngineeringWe are seeking a highly skilled and experienced Director of Software Engineering to join our team at Healthcare Finance Direct LLC. As a key member of our leadership team, you will be responsible for establishing policies and procedures that drive the development of high-quality software products and services.The...


  • Bakersfield, California, United States Good Samaritan Hospital Full time

    Job Title: Utilization Review ClerkGood Samaritan Hospital is seeking a detail-oriented and organized Utilization Review Clerk to join our team. As a key member of our Utilization Review department, you will play a critical role in ensuring compliance with State and Federal regulatory requirements.Job Summary:The Utilization Review Clerk will be responsible...


  • Bakersfield, California, United States InsideHigherEd Full time

    Job SummaryWe are seeking an experienced IT Project Management Director to lead our IT project management office and oversee the management of our IT project portfolio. The successful candidate will have a strong background in IT project management, excellent leadership and communication skills, and the ability to drive successful project planning and...


  • Bakersfield, California, United States InsideHigherEd Full time

    Job SummaryWe are seeking an experienced Associate Director of Enterprise Applications to join our team at Kern Community College District. The successful candidate will be responsible for overseeing the planning, development, maintenance, integration, and enhancement of our Enterprise Resource Planning (ERP) systems and related applications.Key...


  • Bakersfield, California, United States InsideHigherEd Full time

    Job SummaryWe are seeking an experienced IT Project Management Director to lead our IT project management office and oversee the management of our IT project portfolio. The successful candidate will have a strong background in IT project management, excellent leadership and communication skills, and the ability to drive successful project planning and...

  • Medical Director

    4 weeks ago


    Bakersfield, California, United States Kernfamilyhealthcare Full time

    Job DescriptionCompany OverviewKern Family Health Care is a leading healthcare organization dedicated to improving the health status of our members through an integrated managed healthcare delivery system.Job SummaryWe are seeking a highly experienced and skilled Medical Director to provide clinical leadership and guidance in the development and measurement...


  • Bakersfield, California, United States Heritage Provider Network Full time

    Job SummaryHeritage Provider Network is seeking a skilled RN Inpatient Acute Case Manager to join our team. As a key member of our Utilization Review Department, you will be responsible for providing guidance and coordination for inpatient medical records, evaluating patient needs, and facilitating discharge plans.Key ResponsibilitiesAccepts responsibility...


  • Bakersfield, California, United States Telecare Full time

    Job SummaryThe Director of Social Services is a key leadership position at Telecare, responsible for planning, implementing, and directing the Social Services Department. This department provides casework services to members served and their families, and the Director must ensure that these services are delivered in a safe and therapeutically effective...


  • Bakersfield, California, United States InsideHigherEd Full time

    Job Title: Associate Director, IT Project ManagementJoin our team as an Associate Director, IT Project Management, and take on a leadership role in driving successful IT project management initiatives. As a key member of our IT department, you will be responsible for overseeing the IT project management office, providing operational excellence, and leading...


  • Bakersfield, California, United States InsideHigherEd Full time

    Job SummaryWe are seeking an experienced Associate Director, Enterprise Applications to join our team at InsideHigherEd. The successful candidate will be responsible for overseeing the planning, development, maintenance, integration, and enhancement of our Enterprise Resource Planning (ERP) systems and related applications.Key ResponsibilitiesProvide...