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Utilization Management Non Clinical Jobs in California

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Utilization Management Non Clinical information

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.

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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 August 2026, with employment types broken down into 100% Full Time. Highlights an 87% In-person, and 13% Remote job distribution.

Utilization Management Supervisor, Non-Clinical

University of California - Los Angeles Health

Los Angeles, CA • On-site

$70K - $145K/yr

Other

Posted 6 days ago

Job description

Description
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

Qualifications
  • 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

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