Utilization Management Director (RN)

Central California Alliance for Health(1 day ago)

HybridFull TimeSenior$213,000 - $245,000Health Services

About this role

The Utilization Management Director (RN) at the Alliance is responsible for leading and managing the Utilization Management Department, shaping strategies, and ensuring regulatory compliance. The role involves oversight of clinical and operational activities related to healthcare utilization review processes. It is a senior leadership role focused on optimizing healthcare outcomes through evidence-based management and collaboration.

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Required Skills

Utilization Management
Clinical Nursing
Medicaid
Medicare
Managed Care
Regulatory Compliance
Leadership
Team Management
Process Improvement
Healthcare Strategy

About Central California Alliance for Health

thealliance.health

Central California Alliance for Health is a state‑funded Medi‑Cal managed care plan that provides health coverage to residents of Mariposa, Merced, Monterey, San Benito, and Santa Cruz counties. The Alliance coordinates and finances medical, behavioral health, and preventive services through a network of local providers to improve access and health outcomes for its members. It also partners with community organizations and programs to support enrollment, member education, and efforts addressing social determinants of health.

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