Utilization Management Director

3 weeks ago


San Diego, California, United States Kaiser Permanente Full time

**Job Summary:**

We are seeking a highly skilled Utilization Management Director to oversee the day-to-day operations of the Utilization Management Program in the Service Area or a Medical Center. 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 the Service Area or Medical Center related to Utilization Management.
  • Collaborate with multi-disciplinary teams to plan and coordinate care across the continuum.
  • Coordinate and manage member care with non-Kaiser Permanente hospital facilities and providers.
  • Identify risk management and quality of care issues across the continuum.
  • Manage the transportation program to ensure appropriate resource utilization.

**Requirements:**

  • Three (3) years of experience in utilization management and discharge planning in an acute care setting, including 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)

**Additional Requirements:**

  • Demonstrated knowledge of operations and healthcare management, including TJC, Title XXII, Medicare, Medi-Cal, and other local, state, and federal regulations.
  • Knowledge of managed care operations.
  • Interpersonal, negotiation, and management skills.

**What We Offer:**

We offer a competitive salary range of **$120,000 - $180,000** per year, based on experience, as well as a comprehensive benefits package, including health, dental, and vision insurance, retirement savings plan, and paid time off. Located in San Diego, California, we offer a dynamic work environment and opportunities for growth and development.

**Why Kaiser Permanente:**

We are a leader in integrated healthcare, committed to delivering high-quality, patient-centered care. Our team of dedicated professionals is passionate about making a difference in the lives of our members and the communities we serve.



  • San Diego, California, United States Blue Shield of CA Full time

    Your RoleAs the Director of Commercial Utilization Management, you will play a critical role in the success of Blue Shield of California and the Utilization Management department in achieving its goals and objectives.This position requires a seasoned leader who can collaborate with the Utilization Management team to deliver and implement all aspects of...


  • San Diego, California, United States Kaiser Permanente Full time

    Job Summary:As a Manager of Utilization Management at Kaiser Permanente, you will play a critical role in ensuring cost-effective and quality patient care by optimizing resource utilization. You will provide strategic direction to staff, collaborating with multidisciplinary teams to plan and coordinate care across the continuum. Your expertise in healthcare...


  • San Diego, California, United States Kaiser Permanente Full time

    Job Summary:As a Manager of Utilization Management at Kaiser Permanente, you will play a critical role in ensuring cost-effective and quality patient care by optimizing resource utilization. You will lead a team of professionals in developing and maintaining policies and procedures, collaborating with multidisciplinary teams, and coordinating care across the...


  • San Ramon, California, United States Intelecox Full time

    Job Title: Director of Case Management and UtilizationAt Intelecox, we are seeking a highly skilled and experienced Director of Case Management and Utilization to lead our Case Management Department. This is a critical role that requires a strong leader to oversee the effective use of hospital resources, timely and accurate revenue cycle processes, denial...


  • San Francisco, California, United States San Francisco Department of Public Health Full time

    Job SummaryThis is a newly formed unit that will operate under the direction of the Director of BHS Managed Care and the UM Unit Manager. The desired candidate will provide clinical leadership, guidance and support for the team and work in partnership with the UM Unit Manager as Co-Chair of the UM Committee. This position is currently 0.6 FTE. As the unit...


  • San Diego, California, United States Seabreeze Management Full time

    About the Role:We are seeking a highly skilled and experienced General Manager to join our team at Seabreeze Management Company. As a key member of our management team, you will be responsible for overseeing the daily operations of our homeowner associations, ensuring that our clients receive exceptional service and support.Key Responsibilities:Oversee...

  • Project Manager

    4 weeks ago


    San Diego, California, United States Restoration Management Full time

    Job Title: Project DirectorWe are seeking a highly skilled and experienced Project Director to join our team at Restoration Management.Job Summary:The Project Director will be responsible for managing multiple large-scale projects simultaneously, from beginning to end. This includes developing estimates, reviewing and approving time and material billing, and...

  • Executive Director

    4 weeks ago


    San Diego, California, United States Oakmont Management Group Full time

    Job SummaryOakmont Management Group is seeking an experienced Executive Director to lead the day-to-day operations of our senior living community. As a key member of our team, you will be responsible for ensuring the efficient management of our community, providing exceptional care and services to our residents, and maintaining a positive and supportive work...


  • San Diego, California, United States FPI Management, Inc. Full time

    Job SummaryAt FPI Management, Inc., we are seeking a highly skilled and experienced Assistant Community Director to join our team. As a key member of our property operations team, you will be responsible for assisting the Community Director in the day-to-day management of our multifamily properties.Key ResponsibilitiesClient Relations: Maintain positive...

  • Utilization Manager

    4 weeks ago


    San Diego, California, United States Sharp HealthCare Full time

    Job SummaryWe are seeking a highly skilled Utilization Manager to join our team at Sharp HealthCare. As a Utilization Manager, you will play a critical role in ensuring the efficient and effective management of patient care and resources.Key ResponsibilitiesCollaborate with the Centralized Patient Placement Center (CPPC) team to review external and internal...

  • Utilization Manager

    4 weeks ago


    San Diego, California, United States Sharp HealthCare Full time

    Job SummaryWe are seeking a highly skilled Utilization Manager - Transfer and Admission to join our team at Sharp HealthCare. As a key member of our System Integrated Care Management team, you will play a critical role in ensuring the efficient and effective transfer and admission of patients across our healthcare system.Key ResponsibilitiesPartner with the...

  • Safety Specialist

    4 weeks ago


    San Diego, California, United States Insight Global Full time

    About the RoleWe are seeking a highly skilled Safety Specialist - Utility Management to join our team at Insight Global.Key ResponsibilitiesProvide Utility Management Safety Support to ensure the safe and reliable operation of the utility pipeline grid.Apply trade, regulatory, and safety standard knowledge to assist in the safe and reliable operation of the...

  • Operations Director

    4 weeks ago


    San Diego, California, United States Pacific Wealth Management Full time

    Operations Manager Job DescriptionPacific Wealth Management, LLC is seeking a highly skilled and experienced Operations Manager to join our leadership team. As a key member of our team, you will be responsible for overseeing day-to-day business operations and client service.Key Responsibilities:Client Services: Collaborate with our custodial bank, Charles...


  • San Diego, California, United States Sharp HealthCare Full time

    Job Summary:The Transfer and Admissions Utilization Manager plays a critical role in the System Integrated Care Management team, partnering with the Centralized Patient Placement Center (CPPC) RNs to review external and internal transfer requests and direct admission requests. This position supports utilization review functions to ensure appropriate patient...

  • Utilization Manager

    3 weeks ago


    San Diego, California, United States Sharp HealthCare Full time

    Job SummaryWe are seeking a highly skilled Utilization Manager - Transfer and Admission to join our team at Sharp HealthCare. This role will be responsible for reviewing external and internal transfer requests and direct admission requests, ensuring medical necessity and payer considerations are reviewed.The ideal candidate will have a strong background in...

  • Project Director

    4 weeks ago


    San Diego, California, United States San Diego Gas & Electric Full time

    About the RoleWe are seeking a highly skilled Project Director to join our Business Optimization group. As a Project Director, you will be responsible for managing various Capital and Operations & Maintenance projects, primarily focused on process optimization, system enhancements, and continuous improvement initiatives.Key ResponsibilitiesLead and manage...


  • San Diego, California, United States Seabreeze Management Company Full time

    Job DescriptionAt Seabreeze Management Company, we are seeking a highly skilled Community Manager to join our team. The ideal candidate will have a strong background in managing homeowner associations, city government, or related experience.Key Responsibilities:Assist multiple Boards of Directors in developing the overall operational strategy of their...


  • San Diego, California, United States WS Management Full time

    Job OverviewWe are seeking a highly motivated and results-driven Sales & Marketing Manager to join our team at WS Management. The ideal candidate will have a proven track record in hospitality sales, a deep understanding of the local market, and the ability to develop and execute effective sales and marketing strategies.Key Responsibilities:Sales & Business...


  • San Diego, California, United States Discover International Full time

    Program Management Director OpportunityWe are seeking an experienced Program Management Director to join our team at Discover International. This is an exciting opportunity to lead a team of professionals in driving program deliverables and initiatives that meet the goals of our organization.The successful candidate will provide strong leadership and...

  • Director of Finance

    4 weeks ago


    San Diego, California, United States Apap365 Full time

    Job Title: Director of FinanceLa Jolla Music Society (LJMS) is seeking a highly skilled and experienced Director of Finance to join our dynamic team. As a key member of our leadership team, the Director of Finance will be responsible for the overall financial management of LJMS, including managing a $9M annual operating budget, ensuring the accurate and...