Alignment Health

Senior Manager, Inpatient Utilization Management (California LVN / RN Required)

Alignment Health(1 month ago)

HybridFull TimeManager$98,550 - $147,825Utilization Management
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About this role

The Senior Manager, Inpatient Utilization Management at Alignment Health leads the inpatient UM function to ensure efficient, appropriate, and cost-effective care for senior members. The role supports the UM department strategy, liaises with facilities, providers, and families, and represents the organization in clinical and regulatory matters. This position is focused on improving care transitions and driving quality and compliance across inpatient utilization processes.

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Required Skills

  • Leadership
  • Clinical Review
  • Care Coordination
  • Discharge Planning
  • Denials Management
  • Regulatory Compliance
  • Documentation
  • Utilization Management
  • MCG
  • InterQual

+3 more

Qualifications

  • LVN License (California, Non-Compact)
  • RN License (California, Non-Compact)
  • Vocational Nursing Program Completion
  • Registered Nursing Program Completion
  • Bachelor's Degree Preferred (BSN, Health/Clinical, or Business)
  • CCM Certification Preferred
  • ABQAURP Certification Preferred

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