RN Manager/Supervisor Utilization Review Full-time
L.A. Care Health Plan

Supervisor, Utilization Management RN

apartment L.A. Care Health Plan location_onLos Angeles, CA 90017, US
Apply Now

Salary Range:  $102,183.00 (Min.) - $132,838.00 (Mid.) - $163,492.00 (Max.)

 

Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time.

Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.
 

Job Summary

The Supervisor of Utilization Management (UM) RN is responsible for executing the day-to-day operations of the UM department, and monitoring the Care Management (CM) staff’s responsibilities and activities. This includes, but not limited to, ensuring proper staffing and coverage; monitoring and evaluating departmental operations to ensure optimal efficiency, productivity, and effectiveness; documenting and appropriately addressing excellence or deviations in work, departmental, and organizational expectations; and conducting intermittent and annual performance evaluations. This role assists in triaging identified issues/problems and forming resolution within the scope of work/licensure. The Supervisor is a subject matter expert (SME) in Care/Case/Utilization Management and supporting regulations, policies, protocols, and procedures. This position serves as a formal and informal instructor, and escalates issues/concerns to the appropriate person when outside of their scope.

 

This position is responsible in assisting with and development and maintenance of a successful and cohesive unit, with high level of productivity and accuracy to achieve the department's overall performance metrics. The Supervisor ensures all functions of the UM department are operating in accordance with the organization's mission, values and strategic goals, which are focused on quality care delivery and continuous improvement; and are provided in a manner that is responsive and sensitive to the needs of L.A. Care's culturally diverse membership.

 

The position supports the UM Manager/Director. This role also assists UM Educator/Manager/Director in identification of training needs including, but not limited to, collaborating in development of programs, training materials, competency checklist, and orientation checklists necessary to meet education and training needs of UM staff.  The position supervises all aspects of running an efficient team, including hiring, supervising, coaching, training, disciplining, and motivating direct-reports.

Duties

Ensures adequate/appropriate distributions of workforce, assignments and time off requests.  Participates in the hiring and termination process providing recommendations with appropriate supporting documentation.

Monitors of staff's performance including productivity and compliance with regulatory requirements, compliance with policies.  Identifies, communicates and coaches to improve staff performance.  Develops tools, job aids, and workflows to optimize the process flow, performance and productivity of the UM team.  Completes intermittent and annual staff evaluations.

Serves as the primary resource for all business-related questions/issues raised by staff; escalates to appropriate leader/team when necessary.

Recommends and implements process improvement measures to achieve department's performance measures outcomes and goals.

Plans and oversees UM activities according to model of care, program description and policy and procedures to provide timely, quality care and services to members.

Maintains all assigned reporting responsibilities, conducts regular audits to ensure compliance with community, industry and organizational standards including regulatory requirements. Serves as a super-user on electronic programs and systems used by the department.

Assists in the development of programs, workflows, tools, training materials, orientation checklists, and competency checklist necessary to meet educational needs.  Trains new staff, remediation of seasoned staff and cross training as needed in specified business lines.  
 
Serves as a leader and role model as well as technical and informational resource for staff and peers.

Duties Continued

Fosters a culture that encourages employee contribution to ensure that the department maintains an environment in which quality flourishes.

Services as member/resource/liaison to the Interdisciplinary Care Team.  

Recommends resources to improve performance standards in terms of Utilization Management.  Collaborates with peers and colleagues within the organization to address process improvements, member's needs, department and organizational enhancements and communicate development as appropriate.

Participates on internal and external committees as delegated or assigned.

Serves as a consultant to other departments or organizations as needed.

Responsible for the daily workflow and leading the work of assigned staff.  This role will mentor, coach, act as a resource and provide feedback on performance of assigned staff.

 

Performs other duties as assigned.

Education Required

Associate's Degree in Nursing

Education Preferred

Bachelor's Degree in Nursing

Experience

Required:
Minimum of 7 years of acute/clinical care experience.
 

Minimum of 2 years of experience in Case/Care/Utilization Management in an acute care or health plan setting.

 

Minimum of 3 years leading process, program, or staff or supervisory experience.

 

Equivalency:  Completion of the L.A. Care Management Certificate Training Program may substitute for the supervisory/management experience requirement.

Skills

Required:
Knowledge of state, federal and regulatory requirements in Care/Case/Utilization Management.

Strong verbal and written communication skills.

Computer literacy with proficiency with Microsoft Word, Excel, etc. and ability to learn core departmental computer systems and software.

Excellent organizational, time management, and interpersonal skills.

Must be detailed-oriented, energetic, and an enthusiastic team player.

Must be able to work independently.

Licenses/Certifications Required

Registered Nurse (RN) - Active, current and unrestricted California License

Licenses/Certifications Preferred

Required Training

Physical Requirements

Light

Additional Information

Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market.  The range is subject to change.

 

L.A. Care offers a wide range of benefits including

  • Paid Time Off (PTO)
  • Tuition Reimbursement
  • Retirement Plans
  • Medical, Dental and Vision
  • Wellness Program
  • Volunteer Time Off (VTO)

 

Share this job

Share to FB Share to LinkedIn Share to Twitter

Related Jobs

RN Manager/Supervisor Full-time
ScionHealth

Nurse Manager- Float Pool Full Time

apartment ScionHealth location_onWestminster, CA
Description At ScionHealth , we empower our caregivers to do what they do best. We value every voice by caring deeply for every patient and each other. We show courage by running toward the challenge and we lean into new ideas by embracing curiosity and question asking. Together, we create our culture by living our values in our day-to-day interactions with our patients and teammates. Job Summary Responsible for the overall direction and supervision of patient care activities and nursing personnel of a nursing unit(s). Coordinates and consults with the Director of Nursing and Clinical Services (DNCS) and COO/CCO as appropriate in assuring the Standards of Nursing Practice related to all nursing care areas are implemented and followed. Supervises nursing staff, assesses patients, and ensures quality nursing care is provided to all patients on assigned unit(s). Promotes company Policies and Values. Essential Functions Understands the National Quality Program and works towards demonstrated excellence on the unit(s) assigned. Ensures adequate staffing for nursing unit(s) Supervises and evaluates designated nursing staff; assigns duties/assignments and coordinates nursing services based on patient acuity and daily census. Coordinates and directs staff to ensure that patient care is delivered safely and within the scope of hospital policies to meet the needs of the patients. Makes certain the execution of Bedside Shift Reports, Unit briefs and debriefs ensures patient, and staff have been informed of care delivery needs and plans to mitigate any safety issues identified. Coordinates and Incorporates actions needed to further patient care needs. Participates in developing nursing protocol and procedures. Ensures staff is competent to perform all aspects of patient care in an environment that optimizes patient safety and reduces the likelihood of medical/health care errors. Escalates any circumstances, which may have a serious impact. Promotes a Speak Up Culture and support of a High Reliability Organization (HRO). Communicates appropriately and clearly to physicians, staff, and administrative team to ensure adequate and appropriate care delivery. Demonstrates ability to assist staff and physicians with providing patient care if needed; ensures clinical services are conducted and documented appropriately. Assesses and formulates teaching plan based upon identified learning needs and evaluates effectiveness of learning to ensure staff is competent. Maintains supply inventory records; orders supplies and equipment, as necessary. Treats patients and their families with respect and dignity. Identifies and addresses psychosocial, cultural, ethnic, and religious/spiritual needs of patients and family. Functions as liaison between administration, patients, physicians, and other healthcare providers Promotes adherence to the Company's Code of Business Conduct and the Corporate Compliance Agreement by monitoring employee performance and identifying and responding to compliance issues. Knowledge/Skills/Abilities/Expectations Approximate percent of time required to travel 0%. Basic computer skills with working knowledge of Microsoft Office, word processing and spreadsheet software. Must read, write and speak fluent English. Must have good and regular attendance. Performs other related duties as assigned. Pay Range: $55.00-$69.75/hr. ScionHealth has a comprehensive benefits package for benefit-eligible employees that includes Medical, Dental, Vision, 401(k), FSA/HSA, Life Insurance, Paid Time Off, and Wellness. Qualifications Education Bachelor’s degree in nursing required. Licenses/Certifications Registered Nurse in the State Experience Minimum of three years’ experience in healthcare administration/management. Graduate level education may substitute on a year-to-year basis for the required experience.
RN Manager/Supervisor Per Diem
ScionHealth

Nursing Supervisor RN Per Diem Days

apartment ScionHealth location_onWestminster, CA
Description At ScionHealth , we empower our caregivers to do what they do best. We value every voice by caring deeply for every patient and each other. We show courage by running toward the challenge and we lean into new ideas by embracing curiosity and question asking. Together, we create our culture by living our values in our day-to-day interactions with our patients and teammates. Job Summary Supervises nursing staff, assesses patients needs and provides nursing care for patients. Plans and organizes training for unit staff members and participates in guidance and educational programs. Essential Functions Hires, trains, supervises and evaluates designated nursing staff; assigns duties and coordinates nursing services Participates in developing nursing protocol and procedures Provides continuing education and staff development opportunities for nursing staff Assesses patient needs; participates in providing nursing care; ensures services are carried out and documented appropriately Maintains patient health care records Maintains supply inventory records; orders supplies and equipment, as necessary Knowledge/Skills/Abilities/Expectations Supervisory skills and ability to evaluate job performance Ability to make decisions and accept responsibility for work unit Time management skills and ability to organize priorities Ability to maintain confidentiality of all patient and/or employee information to assure patient and/or employee rights are protected Must have good and regular attendance Must read, write and speak fluent English Approximate percent of time required to travel: 0% Performs other related duties as assigned Salary Range: $51.32 - $65.09/Hour ScionHealth has a comprehensive benefits package for benefit-eligible employees that includes Medical, Dental, Vision, 401(k), FSA/HSA, Life Insurance, Paid Time Off, and Wellness. Qualifications Education Degree from an accredited school of nursing Licenses/Certifications Valid state Registered Nurse license Valid BLS certification Experience Two years of nursing experience in a hospital 1 to 2 years supervisory/leadership experience
RN Manager/Supervisor Utilization Review Full-time
Molina Healthcare

Supervisor, Healthcare Services (RN, Utilization Management)

apartment Molina Healthcare location_onLong Beach, CA
** Pacific daytime business hours required. West Coast or Nevada residents preferred JOB DESCRIPTION Job Summary Leads and supervises multidisciplinary team of healthcare services professionals in some or all of the following functions: care management, utilization management, behavioral health, care transitions, long-term services and supports (LTSS), and/or other special programs. Ensures members reach desired outcomes through integrated delivery and coordination of care across the continuum, and contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties • Assists in implementing health management, care management, utilization management, behavioral health and other program activities in accordance with regulatory, contract standards and accreditation compliance. • Functions as a “hands-on” supervisor, assisting with assessing and evaluation of systems, day-to-day operations and efficiency of operations/services. • Assists in the coordination of orienting and training staff to ensure maximum efficiency and productivity, program implementation, and service excellence. • Trains and supports team members to ensure high-risk, complex members are adequately supported. • Assists with staff performance appraisals, ongoing monitoring of performance, and application of protocols and guidelines. • Collaborates with and keeps healthcare services leadership apprised of operational issues, staffing, resources, system and program needs. • Assists with coordination and reporting of department statistics and ongoing client reports, as assigned. • Local travel may be required (based upon state/contractual requirements). Required Qualifications • At least 5 years health care experience, and at least 2 years of managed care experience with utilization management. management or equivalent combination of relevant education and experience. • Registered Nurse (RN) Clinical licensure and/or certification required ONLY if required by state contract, regulation or state board licensing mandates. If licensed, license must be active and unrestricted in state of practice. • Ability to manage conflict and lead through change. • Operational and process improvement experience. • Strong written and verbal communication skills. • Working knowledge of Microsoft Office suite. • Ability to prioritize and manage multiple deadlines. • Excellent organizational, problem-solving and critical-thinking skills. Preferred Qualifications • Registered Nurse (RN). License must be active and unrestricted in state of practice. • Certified Case Manager (CCM), Certified Professional in Health Care Management certification (CPHM), Certified Professional in Health Care Quality (CPHQ) or other health care or management certification. • Medicaid/Medicare population experience. • Clinical experience. • Supervisory/leadership experience. To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V Pay Range: $69,779 - $136,069 / ANNUAL *Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
RN Manager/Supervisor Full-time
Topanga Terrace

Registered Nurse (RN) DAY SHIFT SUPERVISOR 12 HR SHIFT 7AM - 730PM

apartment Topanga Terrace location_onLos Angeles, CA
Topanga Terrace is HIRING NOW – RN Supervisor (Day Shift) 🌞✨ Ready to lead with purpose and grow your nursing career? Join us at Topanga Terrace Rehabilitation & Subacute in West Hills, CA! As our Day Shift RN Supervisor, you’ll be at the heart of the action—guiding care, mentoring staff, and making a direct impact on both residents and their families. Here, you won’t just work a shift—you’ll build skills for a lifetime. Our subacute environment offers hands-on experience caring for ventilator- and tracheostomy-dependent residents, as well as patients on their road to recovery. Whether you’re an experienced nurse or a new grad eager to learn, Topanga Terrace is the place where your clinical career will thrive. 📍 Apply in person today: Topanga Terrace Rehabilitation & Subacute 22125 Roscoe Blvd., West Hills, CA 91304 🌟 What You’ll Do Lead and supervise nursing staff during day-to-day operations Assess residents and develop individualized care plans Provide skilled nursing care—vital signs, wound care, IVs, and medications Support admissions and collaborate with physicians during rounds Engage with residents and families to answer questions and provide support Mentor LVNs and CNAs to deliver compassionate, high-quality care Ensure equipment is working properly and uphold infection-control standards Accurately chart resident progress and monitor safety, including fall prevention 💡 Why Choose Topanga Terrace? Hands-on experience in both subacute and rehab care Day shift leadership role—be the go-to resource for staff and residents New grad friendly—we’ll train and support you every step of the way A supportive, team-focused environment that values your growth ✨ Take the lead in your nursing journey. At Topanga Terrace, you’ll find more than just a job—you’ll find a community that celebrates your growth, supports your success, and makes every day meaningful. Nursing Degree from an accredited school or college Valid RN License in good standing Top of the market wages: $48 - $50 Health insurance Dental insurance Vision insurance Paid time off 401(k) Referral program
RN Manager/Supervisor Full-time
Topanga Terrace

Registered Nurse (RN) NIGHT SUPERVISOR 12 HR SHIFT 7PM - 730AM

apartment Topanga Terrace location_onLos Angeles, CA
Topanga Terrace is HIRING NOW – RN Supervisor (Night Shift) 🌙✨ Looking to grow your career in nursing while making a real difference? Join us at Topanga Terrace Rehabilitation & Subacute in West Hills, CA! We’re not just offering a job—we’re offering an opportunity to build confidence, sharpen your clinical skills, and be part of a team that supports you every step of the way. As an RN Supervisor, you’ll gain valuable experience in both subacute care and short-term rehabilitation. You’ll work with ventilator- and tracheostomy-dependent residents, help patients recover and return home, and guide LVNs and CNAs in providing high-quality care. If you’re a new grad, this is the perfect place to grow into a strong, well-rounded clinical professional! 📍 Apply in person today: Topanga Terrace Rehabilitation & Subacute 22125 Roscoe Blvd., West Hills, CA 91304 🌟 What You’ll Do Lead and supervise nursing staff during your shift Assess residents and develop personalized care plans Provide skilled nursing care, including wound care, IVs, and medications Support admissions, make physician rounds, and ensure accurate charting Collaborate with residents and families—listening and responding to their needs Promote resident safety, monitor for fall risks, and uphold infection-control practices Mentor and support LVNs and CNAs to deliver the best care possible 💡 Why Choose Topanga Terrace? Hands-on training in subacute and rehab care—skills you’ll use your whole career Supportive leadership team invested in your success New grad friendly—we’ll teach, guide, and help you grow A workplace that values teamwork, compassion, and professional development ✨ Take the next step in your nursing journey and build your future with us. At Topanga Terrace, you’re not just joining a facility—you’re joining a family Nursing Degree from an accredited school or college Valid RN License in good standing Must be able to move intermittently throughout the day Work throughout the nursing areas Must be able to lift up to 25 pounds. Lifting more weight up to 100 pounds requires assistance Ability to read fine print on tablet, progress notes, and/or medical labels Top of the market wages: $48 - $50 Differential for RNs at night Health insurance Dental insurance Vision insurance Paid time off 401(k) Referral program