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Utilization Management Non Clinical information

Can you do a utilization review without being a nurse?

Utilization Management Non Clinical roles typically do not require a nursing license, as they focus on reviewing medical necessity and appropriateness of services based on guidelines and policies. These positions often require strong analytical skills, knowledge of healthcare policies, and sometimes certifications like Certified Professional in Healthcare Quality (CPHQ), but do not usually mandate nursing credentials.

Which non-clinical healthcare jobs pay the most?

In non-clinical healthcare roles, positions such as healthcare administrators, health information managers, and utilization management directors tend to have the highest salaries. These roles often require advanced degrees, certifications, and strong management or technical skills, and they typically offer six-figure compensation depending on experience and location.

What jobs pay 4000 a week without a degree?

Utilization Management Non Clinical roles typically do not pay $4,000 a week without a degree, as they often require healthcare knowledge or certifications. High-paying jobs that can reach this level without a degree include certain sales positions, real estate brokers, or specialized trades like commercial pilots or skilled trades, which may require licenses or experience. Most roles paying this amount without a degree involve sales, entrepreneurship, or skilled labor with relevant certifications or experience.

What is the difference between Utilization Management Non Clinical vs Utilization Review Nurse?

AspectUtilization Management Non ClinicalUtilization Review Nurse
CredentialsCertifications like CCM, RN (optional), but primarily non-clinical certificationsRN license, certifications such as CCM or CUC
Work EnvironmentOffice-based, administrative setting, telecommuting optionsClinical settings, hospitals, or insurance companies, often with direct patient or provider interaction
Employer & Industry UsageHealth insurance companies, managed care organizationsHospitals, insurance companies, healthcare providers
Search & Comparison IntentUnderstanding non-clinical roles in utilization managementClinical review roles involving direct patient care assessment

Utilization Management Non Clinical roles focus on administrative, policy, and documentation tasks without direct patient care, while Utilization Review Nurses perform clinical assessments to determine care necessity. Both roles are essential in healthcare utilization but differ mainly in clinical involvement and required credentials.

What is an example of a non-clinical position?

A non-clinical position in utilization management, such as Utilization Management Non-Clinical roles, involves reviewing medical records and insurance policies to determine coverage and appropriateness of care without direct patient interaction. These roles typically require knowledge of healthcare policies, strong analytical skills, and familiarity with healthcare management systems.
What are popular job titles related to Utilization Management Non Clinical jobs in California? For Utilization Management Non Clinical jobs in California, the most frequently searched job titles are:
What job categories do people searching Utilization Management Non Clinical jobs in California look for? The top searched job categories for Utilization Management Non Clinical jobs in California are:
What cities in California are hiring for Utilization Management Non Clinical jobs? Cities in California with the most Utilization Management Non Clinical job openings:
Utilization Management Non Clinical jobs near you
Infographic showing various Utilization Management Non Clinical job openings in California as of July 2026, with employment types broken down into 100% Full Time. Highlights an 86% In-person, and 14% Remote job distribution.
Utilization Management Supervisor, Non-Clinical

Utilization Management Supervisor, Non-Clinical

UCLA Health

Los Angeles, CA • On-site

$70K - $145K/yr

Full-time

Posted 10 days ago

UCLA Health rating

8.7

Company rating: 8.7 out of 10

Based on 136 frontline employees who took The Breakroom Quiz

7th of 890 rated healthcare providers

Job description

General Information
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Work Location: Los Angeles, CA, USA
Onsite or Remote
Flexible Hybrid
Work Schedule
Monday - Friday, 8:00am - 5:00pm PST
Posted Date
06/15/2026
Salary Range: $70900 - 145200 Annually
Employment Type
2 - Staff: Career
Duration
Indefinite
Job #
31067
Primary Duties and Responsibilities
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Under the direction of the Utilization Management Assistant Director, the Utilization Management Supervisor (Non-Clinical) oversees the daily operations of non-clinical patient navigation services supporting high-risk and high-utilizer patient populations within the Utilization Management Department. This role supervises a team of coordinators, patient navigators and concurrent nurses, ensuring efficient workflow management, timely access to care, effective care transitions, and high-quality service delivery.
Key Responsibilities
  • Supervise and provide leadership to Patient Navigators and Coordinators supporting UM, SNF, ED follow-up, and Home Health workflows.
  • Oversee patient navigation activities, including appointment scheduling, transportation coordination, DME coordination, and community resource referrals.
  • Monitor operational work queues, referrals, discharge tracking, and care transition activities to ensure timely follow-up and service delivery.
  • Support effective transitions of care through post-discharge outreach, appointment adherence, and coordination of services.
  • Collaborate with interdisciplinary teams to identify and address barriers to care and support patient engagement initiatives.
  • Manage staff performance, scheduling, attendance, payroll/timekeeping, training, and professional development.
  • Analyze operational and utilization data to support quality improvement, compliance, and strategic decision-making.
  • Lead process improvement initiatives and support the development and optimization of departmental workflows, policies, and procedures.
  • Support system-related functions and operational activities related to care coordination, authorizations, and utilization management workflows.

Salary Range: $70,900 - $145,200/Annually
Job Qualifications
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  • High school diploma, GED or equivalent experience.
  • Four or more years of experience in a Managed Care Case Management and care coordination environment - REQUIRED
  • Three or more years of experience in Inpatient and ambulatory Managed Care program/referrals - REQUIRED
  • Three or more years of leadership or Supervisory role - REQUIRED
  • Two or more years of
    • Experience supporting Intensive Case Management, Utilization Management, Skilled Nursing Facility, and Home Health programs
    • Familiarity with Medicare Advantage and value-based care models
    • Experience with electronic health records (e.g., Epic/CareConnect)
  • Four years or more experience in Managed care Organization, Medical Group operations, Health Plan administration and workflows.
  • 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 - Preferred

As a condition of employment, the final candidate who accepts an offer of employment will be required to disclose if they have been subject to any final administrative or judicial decisions within the last seven years determining that they committed any misconduct; or have filed an appeal of a finding of substantiated misconduct with a previous employer.
Current/former UC employees are subject to a personnel file review.

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About UCLA Health

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UCLA Health, operating within the healthcare industry, is significantly recognized for its commitment to improving the health and wellbeing of people through the integration of patient care, research, and education. Located in Los Angeles, California, UCLA Health was founded and associated with the University of California, Los Angeles (UCLA) in 1955, entrenching its roots in quality healthcare service provision. Through a broad range of medical services, UCLA Health significantly stands as a cornerstone for comprehensive outpatient, inpatient, and emergency care services, specialized treatments, and wellness checks. Notable for pioneering an integrated, comprehensive medical approach, UCLA Health is consistently ranked among the top health systems in the US and world.

Industry

Health care and social assistance

Company size

10,000+ Employees

Headquarters location

Los Angeles, CA, US

Year founded

1955

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