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Weekend Supervisor Utilization Management Jobs in California

KPC Health

Utilization Review Tech

Santa Ana, CA · On-site

Utilization Review Technician Under direction of the Utilization Review Technician Supervisor, the Utilization Review Technician coordinates with the Utilization Management Department while being ...

KPC Global MSO

Utilization Review Tech

Santa Ana, CA · On-site

SUMMARY Under direction of the Utilization Review Technician Supervisor, the Utilization Review Technician coordinates with the Utilization Management Department while being responsible for ...

Sutter Health

Utilization Review Tech III

San Mateo, CA · On-site

$48.91 - $68.47/hr

Reports out monthly (and as needed) on denials and other utilization management subjects ... Variable Weekend Requirements: None Benefits: Yes Unions: No Position Status: Non-Exempt Weekly ...

Sutter Health

Utilization Review Tech III

San Mateo, CA · On-site

$48.91 - $68.47/hr

Reports out monthly (and as needed) on denials and other utilization management subjects ... Variable Weekend Requirements: None Benefits: Yes Unions: No Position Status: Non-Exempt Weekly ...

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Weekend Supervisor Utilization Management information

What does a weekend supervisor in utilization management do?

A Weekend Supervisor in Utilization Management oversees the review and coordination of patient care services during weekends to ensure appropriate use of healthcare resources. They manage a team of utilization review staff, ensure compliance with policies, and facilitate communication between healthcare providers and insurance companies. Their role is critical in making timely decisions about patient admissions, continued stays, and discharges, focusing on quality care and cost efficiency. They also handle escalations and provide support to staff working outside of regular business hours.

What are the primary challenges a weekend supervisor in utilization management faces, and how can they be addressed?

Weekend Supervisors in Utilization Management often encounter challenges such as limited staff availability, high patient volume, and the need for rapid decision-making with less direct access to physicians or ancillary services. To address these, strong organizational skills, proactive communication, and the ability to prioritize urgent cases are essential. Supervisors should foster a collaborative atmosphere, leverage digital tools for efficient workflow, and ensure clear escalation protocols for complex cases, all while maintaining regulatory compliance and quality patient care.

What are the key skills and qualifications needed to thrive as a weekend supervisor in utilization management, and why are they important?

To thrive as a Weekend Supervisor Utilization Management, you need a comprehensive understanding of clinical guidelines, utilization review processes, and healthcare regulations, typically supported by a nursing degree (RN) or related clinical licensure. Familiarity with utilization management software, electronic health records (EHRs), and knowledge of relevant accreditation standards (such as URAC or NCQA) are essential. Strong leadership, decision-making, and effective communication skills help navigate team dynamics and complex case reviews during weekend shifts. These skills ensure efficient resource management, compliance with healthcare standards, and consistent quality of care even outside regular business hours.

What is the difference between Weekend Supervisor Utilization Management vs Weekend Utilization Review Coordinator?

AspectWeekend Supervisor Utilization ManagementWeekend Utilization Review Coordinator
CredentialsTypically requires a healthcare-related license or certification (e.g., RN, LPN, or case management certification)Often requires similar healthcare credentials, such as RN or case management certification
Work EnvironmentSupervises utilization management staff, oversees case reviews, and ensures compliance during weekendsPerforms case reviews, evaluates medical necessity, and coordinates utilization decisions during weekends
Employer & IndustryHospitals, insurance companies, healthcare organizationsHospitals, insurance providers, healthcare organizations

The main difference is that the Weekend Supervisor Utilization Management role involves supervising staff and managing utilization processes, while the Weekend Utilization Review Coordinator focuses on conducting case reviews and making utilization decisions during weekends. Both roles require healthcare credentials and operate within similar environments, but their responsibilities differ in scope and leadership level.

What are the most commonly searched types of Supervisor Utilization Management jobs in California?

The most popular types of Supervisor Utilization Management jobs in California are:

What are popular job titles related to Weekend Supervisor Utilization Management jobs in California?

For Weekend Supervisor Utilization Management jobs in California, the most frequently searched job titles are:

What job categories do people searching Weekend Supervisor Utilization Management jobs in California look for?

The top searched job categories for Weekend Supervisor Utilization Management jobs in California are:

What cities in California are hiring for Weekend Supervisor Utilization Management jobs?

Cities in California with the most Weekend Supervisor Utilization Management job openings:

Weekend Supervisor Utilization Management jobs near you

RN Weekend Supervisor-Saturday-Sunday

WILLOW CREEK HEALTHCARE CENTER, LLC

Clovis, CA • On-site

$42 - $45/hr

Other

Posted 6 days ago

Job description

RN Weekend Supervisor
Willow Creek Health Care Center
Pay Range: $42-$45 per hour
Position Summary
The RN Weekend Supervisor is responsible for coordinating and overseeing resident care services during weekend operations to ensure high-quality, safe, and efficient clinical care. This role serves as a key clinical liaison between residents, families, physicians, interdisciplinary team members, and payers while ensuring compliance with regulatory standards and facility policies.
The RN Weekend Supervisor promotes a collaborative, resident-centered environment and ensures care delivery aligns with each resident's individualized Plan of Care.
Essential Duties and Responsibilities

  • Communicate regularly with residents and families regarding Plans of Care, PT, OT, and other treatment protocols.
  • Attend and actively participate in morning meetings/stand-up meetings to facilitate interdisciplinary communication.
  • Answer residents' and families' questions regarding care, treatment plans, and condition progression to ensure comfort and confidence in care delivery.
  • Monitor resident status and adjust care interventions based on changing conditions.
  • Organize and prioritize daily workflow by assessing new admissions, current residents, and pending discharges.
  • Complete all required clinical documentation accurately and timely.
  • Perform utilization review activities to ensure appropriate, timely, and cost-effective care.
  • Coordinate care between residents, providers, financial services, and third-party payers.
  • Oversee admissions and discharge processes to ensure smooth transitions of care.
  • Coordinate referrals both to and from the facility.
  • Maintain accurate charting and complete necessary paperwork in a timely manner.
  • Exercise independent judgment when interacting with physicians, providers, payers, residents, and families.
  • Promote collaboration and teamwork among interdisciplinary partners.
  • Demonstrate excellent time management skills in a fast-paced, high-volume environment.
  • Maintain professionalism, respect, and integrity in all interactions.
Supervisory Responsibilities
This position has no direct supervisory responsibilities but serves as a clinical leader and resource during weekend operations.
Qualifications
Education and Experience
  • Bachelor's Degree in Nursing or Social Work preferred.
  • Active Registered Nurse (RN) license required; LVN/LPN considered.
  • Minimum two (2) years of clinical nursing experience preferred.
  • Knowledge of Medicare, Medi-Cal, and Medicaid programs and benefits.
  • PCC experience preferred.
Language Skills
  • Ability to read technical procedures and policy manuals.
  • Ability to effectively present information and respond to questions from managers, employees, residents, and families.
Mathematical Skills
  • Ability to apply fractions, percentages, ratios, and proportions in practical clinical situations.
Reasoning Ability
  • Ability to solve practical problems and interpret written, oral, and diagram-based instructions.
Certificates, Licenses, and Registrations
  • Valid RN, LVN, or LPN license in the state of employment.
  • Certified Case Manager (CCM) certification a plus.
  • Must maintain required continuing education and licensure.
  • Must remain in good standing with the Department of Public Health, License and Certification Division.
Physical Demands
The essential functions of this position require:
  • Frequent standing and walking.
  • Occasional sitting.
  • Frequent reaching, pushing, pulling, talking, hearing, tasting, and smelling.
  • Frequent lifting up to 50 pounds.
  • Occasional climbing, balancing, stooping, kneeling, crouching, or crawling.
  • Close, distance, color, peripheral, and depth perception with the ability to adjust focus.
Work Environment
This position operates within a skilled nursing environment. The noise level is typically low to moderate. Reasonable accommodations may be made to enable individuals with disabilities to perform essential job functions.
Additional Information
Nothing in this job description restricts management's right to assign or reassign duties and responsibilities at any time. This description reflects the general nature and level of work performed and is not intended to be an exhaustive list of responsibilities.
Equal Employment Opportunity Statement
Willow Creek Health Care Center is an Equal Opportunity Employer. We are committed to providing equal employment opportunities to all employees and applicants and prohibit discrimination and harassment of any type without regard to race, color, religion, sex, gender identity or expression, sexual orientation, national origin, age, disability, genetic information, marital status, veteran status, or any other characteristic protected by federal, state, or local law.
We are an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status, or any other legally protected status.

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