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The parent companies of Rady Children’s and Children’s Hospital of Orange County (CHOC) have merged, creating a new combined healthcare system called Rady Children’s Health. To see our career opportunities at CHOC, visit choc.org/careers.

Manager, Utilization Management Operations - Utilization Management

San Diego, California
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Job ID 16093 Date posted 02/17/2025 Schedule Full-Time Shift Day Department Utilization Management

JOB SUMMARY:

Under the supervision of the Director, UM Operations, the Manager, UM Operations oversees and coordinates operations across multiple health plans in the Southern California area and ensures consistent quality service in both authorization processing and in completion of phone calls.

MINIMUM QUALIFICATIONS:

Bachelor's Degree

5 Years of Experience

Minimum 5 years supervisory experience in managed care, at a health plan or medical group level

Knowledge of health plan processes, benefits, authorizations, claims, and ICD-10/CPT coding required

Advanced computer skills, specifically Excel, EZ Cap, Word, Outlook, Internet/Web searching, Epic, Calabrio, and ACD phone systems.

Statistical analysis experience required.

Demonstrated commitment to valuing diversity and contributing to an inclusive working and learning environment

PREFERRED QUALIFICATIONS:

7 Years of Experience

The current salary range for this position is $41.49 to $57.05

Rady Children’s Hospital is committed to compensation that is externally competitive and internally equitable. We demonstrate this commitment by conducting regular market reviews to remain competitive with organizations of similar size in the nonprofit, healthcare sector. The range listed above does not represent the full salary range for the position but is the expected hiring range for qualified candidates. Compensation decisions consider a variety of factors including experience, education, licensure, unique skillsets, organizational need, and internal equity. This posting will remain open from the “date posted” until the hiring manager has determined there is a sufficient applicant pool or until the position is filled.

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