Manager of Utilization Management, RN

Harbor City, California

Overview
Success Profile
Benefits
Our Culture
What Our People Are Saying
Job Requirements
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Our nurse leaders maintain a strong commitment to the highest standards of professional nursing practice and to sustain a culture of excellence. You will encourage your teams to use evidence-based practice to deliver high-quality patient care, contribute to research, and spread innovation beyond Kaiser Permanente. Backed by the resources of one of the nation’s largest health care providers, you’ll motivate and inspire your team to achieve goals, value individual contributions, and celebrate accomplishments in meaningful ways while realizing your own potential as a leader.

Job Type: Full-time
Job Level: Manager with Direct Reports
Travel: No

Success Profile

We’re looking for Nurse Leaders who possess the following traits.

Adaptable
Collaborative
Compassionate
Leadership
Problem-Solver
Results-Oriented

Benefits

Our compensation and benefits are designed to help you and your family stay healthy and thrive.

Medical, Vision & Dental
Retirement Plans
Tuition Reimbursement
Tuition Reimbursement
Supportive Team & Resources
Career Growth & Development

Our Culture

Our Nurse Leaders cultivate an environment of compassion, integrity, trust, and open communication that helps our teams do their best work. Together, we pursue lifelong learning in the belief that it expands our knowledge so we can better serve our patients. We participate in research to inform our evidence-based care. Our nurses reflect the rich diversity of our members and communities, and provide culturally responsive and competent care that promotes the understanding of our members’ needs and preferences. At Kaiser Permanente, nurses are highly skilled professionals who exemplify leadership, critical thinking, and collaborative problem-solving, and deliver the right care, at the right time, in the right setting.

What Our People Are Saying

Ghada, PhD, RN, NEA-BC, CENP

SCAL Regional Director
Patient Care Services

“So proud to be a Kaiser Permanente nurse leader. Despite all the challenges we experienced with the pandemic, we remained true to our mission to provide safe, quality care to our patients and members, and continue to encourage our employees to grow and develop professionally. I have completed my Doctor of Philosophy in Nursing and lead with an exceptional team. There are boundless opportunities here.”

Gertrude, RN, BSN, MSA

Administrative Service Director
Nursing Administration

“Kaiser Permanente has a mission of providing affordable health care not just for our members, but also the community — which is a passion of mine. I consider myself very fortunate to work for an organization that values their employees. As a nurse leader, I LOVE what I do! We provide endless possibilities for growth and professional development.”

Michele, JD, MBA, RN

Director
Nursing Professional Development and
Simulation/Magnet Journey

“Kaiser Permanente provides its nurse leaders with opportunities to innovate and thrive in an evidence-based practice that’s advancing the science of nursing and embracing a culture of excellence.”

Philidah, MSN, RN

Sr. Director of Nursing

“It’s a privilege to work for Kaiser Permanente. They support nurses through a variety of learning opportunities, from self-paced learning to leadership courses and stretch assignments. It enables equitable opportunities for professional growth and career advancement.”

Mervin

Assistant Medical Center Administrator

“I’m incredibly grateful for the support I received from Kaiser Permanente. I would not be where I am right now without the mentoring from outstanding leaders, the strong relationships I built with my team, and the partnership with other departments.”

Melissa

Assistant Nurse Manager

“I’m in my first position here, but I’ve already had the opportunity to be part of the Magnet Journey, quality and safety committees, and co-chair Professional Nursing Excellence Council. Kaiser Permanente continues to help me grow through leadership training programs like Activate and stretch assignments.”

Aletha

Department Manager

“Kaiser Permanente has many resources and tools to help us grow professionally. We have courses and financial aid for individuals who choose to advance.I love being a leader because I love to encourage, inspire, and develop my team. I also embrace challenges and enjoy collaborating in projects that positively impact our members.”

Adriana

Department Manager RN

“Kaiser Permanente allows me to focus on preventive health care, which contrasts with my acute care background. I appreciate the preventive care services that we offer our members and the different forms of communication based on personal preference.”

Manager of Utilization Management, RN

Primary Location Harbor City, California Facility South Bay Medical Center Job Number 1193202 Date posted 11/27/2023

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Description:

Manages the day-to-day operations of the Utilization Management Program in the Service Area or a Medical Center. Ensures cost effective and quality patient care by appropriate utilization of resources. Provides direction to staff which may include Outside Utilization, Extended Care, Bed Placement, Discharge Planning, Transportation and others as assigned.

Essential Responsibilities:

Assists in developing and maintaining policies and procedures for the Service Area or Medical Center related to Utilization Management.

Collaborates with the multi-disciplinary teams to plan and coordinate care across the continuum.

Coordinates and manages members' care with non-KFH hospital facilities and providers. Identifies risk management and quality of care issues across the continuum.

Surfaces issues and any suggestions to the appropriate multi-disciplinary team members.

Manages transportation program to ensure appropriate utilization of resources which meet Health Plan guidelines and patient needs.

Assures compliance with Federal, State, TJC, NCQA, other regulatory agencies and internal standards and requirements.

Provides direction to staff regarding utilization review, care coordination, discharge planning, and other services across the continuum of care.

Assists in conducting statistical studies in utilization trends, patterns, and outcomes.

Hires, trains coaches, disciplines professional and clerical support staff.

Basic Qualifications:

Experience

Minimum three (3) years of experience in utilization management and discharge planning in an acute care setting to also include supervisory or management experience.

Education

BSN or bachelor's degree in healthcare related field such as management, health services administration.

License, Certification, Registration

Current California RN license.

Additional Requirements:

Demonstrated knowledge of operations and healthcare management; TJC, Title XXII, Medicare, MediCal and other local, state and federal regulations.

Knowledge of managed care operations.

Demonstrated interpersonal, negotiation, and management skills.

Good oral and written communication skills.

Must be able to work in a Labor/Management Partnership environment.

Preferred Qualifications:

N/A.

Primary Location: California,Harbor City,South Bay Medical Center Scheduled Weekly Hours: 40 Shift: Day Workdays: Mon, Tue, Wed, Thu, Fri Working Hours Start: 08:30 AM Working Hours End: 05:00 PM Job Schedule: Full-time Job Type: Standard Employee Status: Regular Employee Group/Union Affiliation: NUE-SCAL-01|NUE|Non Union Employee Job Level: Manager with Direct Reports Department: South Bay Med Center - Hospital Administration - 0801 Pay Range: $136200 - $176220 / year The ranges posted above reflect the location in the job posting. The salary range may vary if you reside in a different location or state than the location posted. Travel: No At Kaiser Permanente, equity, inclusion and diversity are inextricably linked to our mission, and we aim to make it a part of everything we do. We know that having a diverse and inclusive workforce makes Kaiser Permanente a better place to receive health care, a more supportive partner in our communities we serve, and a more fulfilling place to work. Working at Kaiser Permanente means that you agree to and abide by our commitment to equity and our expectation that we all work together to create an inclusive work environment focused on a sense of belonging and wellbeing.

Kaiser Permanente is an equal opportunity employer committed to a diverse and inclusive workforce. Applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), age, sexual orientation, national origin, marital status, parental status, ancestry, disability, gender identity, veteran status, genetic information, other distinguishing characteristics of diversity and inclusion, or any other protected status. Submit Interest

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Navigating the Hiring Process

We're here to support you!

Having trouble with your account or have questions on the hiring process?

Please visit the FAQ page on our website for assistance.

Need help with your computer and browser settings?

Please visit the Technical Information page for assistance or reach out to the web manager at kp-hires@kp.org.

Do you need a reasonable accommodation due to a disability?

Reasonable accommodations may be available to facilitate access to, or provide modifications to the following:

Online Submissions
Pre-Hire Assessments
Interview Process

If you have a disability-related need for accommodation, please submit your accommodation request and someone will contact you.

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We're proud to share that for the second year in a row, 100% (39 of 39) of our hospitals rated high-performing (top 20% in the nation) for at least 1 of the 35 measures in the U.S. News & World Report. Seventeen of our hospitals ranked among their state's Top 50 and two ranked in the nation's Top 50 for a specialty.