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Supervisor of UM - $5000 Sign-On Bonus for External Candidates! (744385)

Position Description

For those who want to invent the future of health care, here's your opportunity. We're going beyond basic care to health programs integrated across the entire continuum of care. Join us and help people live healthier lives while doing your life's best work.(sm)


The Supervisor of Utilization Management functions as first line management for the Utilization Management Department and provides oversight for the clinical Utilization Management staff. Responsibilities entail Utilization Management activities within the department that may include: staffing issues, Utilization Management audits, project management, staff development, quality management, as well as training.
Supervisor of Utilization Management- Redlands,CA $5k Sign-On Bonus!
Primary Responsibilities:
  • Actively evaluates caseloads and appropriate distribution of work
  • Achieve workflow modifications to maximize efficiency
  • Assist Utilization Management Manager in developing and implementing and monitoring the quality assurance process
  • Identify compliance and quality improvement opportunities and initiate corrective actions
  • Assist Utilization Management Manager in implementing procedures to provide excellent customer service to our clients through but not limited to communication, staffing, phone availability and service execution
  • Responsible for reviewing case audits with staff and pre-certification approvals
  • Identify issues, training needs, and develop processes within the Utilization Management departments
Required Qualifications:
  • Current LVN or RN license in the state of California
  • 2+ years of Utilization Management experience
  • 2+ years of Managed Care / IPA / Health plan experience
  • 2+ years of Supervisory / Management experience
  • Computer proficiency in MS Office: Outlook, Word, Excel, PowerPoint
Preferred Qualifications:
  • Case Management experience in IPA / Hospital setting
  • BSN
  • Experience with pre-certification referrals

Careers with Optum. Here's the idea. We built an entire organization around one giant objective; make the health system work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do your life's best work.(sm)

North American Medical Management, California, Inc (NAMM California) partnered with OptumHealth in 2012. NAMM California and OptumHealth share a common goal of bringing patients, physicians, hospitals and payers closer together in the mission to increase the quality, efficiency and affordability of care. NAMM California is a part of the family of companies that make UnitedHealth Group one of the leaders across most major segments of the US health care system. NAMM California develops and managers provider networks, offering a full range of services to assist physicians and other providers in supporting patient care coordination and their managed care business operations. For over 18 years, NAMM California has been an innovator in health care with a track record for quality, financial stability, extraordinary services and integrated medical management programs. NAMM California is well positioned to continually invest in its infrastructure and systems for the benefit of its provider clients and to accommodate the impending changes that will come forth from healthcare reform.


The NAMM California provider clients represent a network of almost 600 primary care physicians and over 3,000 specialists and work with the premier hospitals in their respective markets.



Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.



Job Keywords: UM, RN, LVN, Supervisor, manager, managed care, IPA, health plan, BSN, referrals, audits, QA, Redlands, Rancho Cucamonga, Ontario, Inland Empire, CA


Job Details

  • Contest Number744385
  • Job TitleSupervisor of UM - $5000 Sign-On Bonus for External Candidates!
  • Job FamilyNursing
  • Business SegmentOptumCare

Job Location Information

  • Redlands, CA
    United States
    North America

Additional Job Detail Information

  • Employee StatusRegular
  • ScheduleFull-time
  • Job LevelManager
  • ShiftDay Job
  • TravelNo
  • Telecommuter PositionNo
  • Overtime StatusExempt