Description Required Education: -Bachelor's degree in a health care-related field. Required Certifications & Licensure: -Active CA RN License. Required Skills & Experience: -Registered Nurse (RN) in the State of California. -At least 3 to 5 years of Nursing Management Experience in a Medical Group, Hospital, Health Plan or Risk-Based MSO setting. -At least 5-10 years of Nursing Experience in a Medical Group, Hospital, Health Plan or Risk-Based MSO setting. DIRECT HIRE, 100% Remote Mon-Fri 8-5, expectation for on-call availability Expected range could be between $57.09-$94.18/hr DOE. -This is a mangerial role - managing both RNs and other non-clinical staff, team size is 15. -This manager will act as the UM SME for their team, managing escalations. -Candidates must have prior authorization experience (ambulatory, health plans). If candidates have only inpatient or concurrent review UM experience, that will not be sufficient for the role. -Candidates should have prior health plan experience -Must have prior experience managing UM for California -Need someone familiar with audits in UM -SW used in role EPIC Tapestry and MCG (not required to have this experience, can train) Role reports to UM Director. Salary 75.00 - 75.50 Hour
