About the role
WelbeHealth is hiring a Utilization Management RN to help lead its UM team in Los Angeles, CA, ensuring seniors in its PACE program get timely, quality, compliant and cost-effective care. You'll oversee day-to-day UM operations, review prior-authorization requests for medical necessity, develop staff competency, and collaborate with providers to resolve utilization issues. Compensation is $99,310–$131,089/year plus bonus.
Responsibilities
- Provide direct oversight of day-to-day operations within the UM team
- Review prior-authorization requests for medical necessity and appropriateness
- Build orientation and competency development for staff reviewing authorizations
- Collaborate with internal and external providers to resolve UM issues
Requirements
- Active RN license with 3+ years of relevant clinical nursing experience
- 2 years of supervisory experience mentoring and developing teams
- Strong preference for prior PACE experience
What we offer
- $99,310–$131,089/year plus bonus
- Medical, dental and vision; 401(k) with match
- 17 days PTO, 12 holidays and sick time
- Advancement opportunities with a track record of promoting from within