What are the responsibilities and job description for the Manager, Utilization Management Nurse Management (Prior Authorization) position at Blue Shield of CA?
Your RoleThe Utilization Management Prior Authorization team ensures accurate and timely prior authorization of designated healthcare services, continuity or care, and access to care clinical review determinations. The Manager, Utilization and Medical Review will report to the Sr. Manager, Utilization and Medical Review. In this role you will be managing a high functioning team, have direct oversight of day-to-day operations and participate in process improvement / cost of health care initiatives. Our leadership model is about developing great leaders at all levels and creating opportunities for our people to grow - personally, professionally, and financially. We are looking for leaders that are energized by creative and critical thinking, building, and sustaining high-performing teams, getting results the right way, and fostering continuous learning.Your Knowledge and ExperienceRequires a bachelor's Degree or equivalent experienceRequires a current California RN LicenseRequires at least 7 years of prior relevant experience including 3 years of management experienceHas demonstrated experience with basic management approaches such as work scheduling, prioritizing, coaching, process execution, work organization, inventory management, risk management and delegationKnowledge of regulatory requirements for all Lines of Business (Medi-Cal, ASO / SA, IFP, Medicare Advantage) preferredRequires strong emotional intelligence skillsRequires the ability to work collaborative with cross functional operationsPay Range : The pay range for this role is : $ 109120.00 to $ 163680.00 for California.Note : Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.#LI-RU1
Salary : $109,120 - $163,680
