UC Davis Medical Center

Sacramento, CA

Department Manager of Managed Care & Utilization Management

Salary or Pay Range: $129,000.00 - $294,000.00

The Manager works closely with the Medical Director to develop efficient systems and methods for delivery of high-quality clinical care to UC Davis Medical Group patients. The incumbent’s work is performed with full independence, based on prior agreements and arrangements, and subject to administrative review and approval. The incumbent will provide direction concerning the overall goals and objectives of the department in all aspects, including clinical quality, financial and operational.

Minimum Qualifications - For full consideration, applicants are encouraged to upload license and/or certification if required of the position

• Valid California Registered Nurse License.

• Bachelor's in Nursing is required.

• Minimum 5 years HMO/Utilization Management experience with capitated plans.

• Ability to organize and direct varied health care teams in a manner that establishes a good rapport and professional working relationship. 

• Ability to work efficiently and independently in a calm manner, under pressure. 

• Ability to organize work to accommodate special projects, deadlines and priorities. 

• Leadership skills to direct others of varying job levels to accomplish tasks in a positive manner that are conducive to positive outcomes. 

• Skill to assess learning needs of staff and to participate in their training development to promote growth within their position and the university. 

• Written communication skills to clearly and concisely compose letters, performance evaluations, reports, policies and procedures that could include clinical, financial and administrative information. 

• Verbal communication skills to clearly and concisely receive, elicit, and convey information of a clinical, financial, or administrative nature to a variety of individuals within and outside the university.

• Knowledge of University Personnel policies and procedures and various employee bargaining unit contracts. 

• Ability to work with all levels of staff, both inter- and intra-departmentally to create cooperative relationships and positive working environment.

Preferred Qualifications

• Masters Degree is preferred. 

• Additional preferred experience in appeals/grievance management, case management and network management. 

• Broad-based clinical experience. 

• Knowledge of California HMO statutes and regulations, procedures and regulations regarding benefits, services and restrictions in relation to both utilization management and continuity of care, specifically the Knox Keene Act.

• Skills applying National Committee for Quality Assurance UM standards to an HMO product.

• Knowledge of Epic.

Key Responsibilities

• 30% - Responsibility Delegated Utilization Management

• 60% - Managed Care and Utilization Management Unit Operations

• 5% - Committee Membership

• 5% - Professional Development

Special Requirements – Please contact your recruiter with questions regarding which activities apply by position

• This is a critical position, as defined by UC Policy and local procedures, and as such, employment is contingent upon clearing a criminal background check(s) and may include drug screening, medical evaluation clearance and functional capacity assessment 

• This position is designated as a mandated reporter under CANRA and UC policy, and employment is contingent on compliance with applicable policies, procedures and training requirements

To view full job description and submit an on-line application visit UC Davis Career Opportunities at:

http://50.73.55.13/counter.php?id=300737

Job ID #77476

The University of California, Davis is an Affirmative Action/Equal Opportunity Employer