Utilization Management Manager - Managed Services Organization (MSO)Human Compass Staffing • Los Angeles, CA, US
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Utilization Management Manager - Managed Services Organization (MSO)
Human Compass Staffing • Los Angeles, CA, US
4 days ago
Job type
- Full-time
Job descriptionActive CA RN or LVN license required 5+ years UM experience in managed care or MSO environment 2+ years leadership / supervisory experience Strong knowledge of NCQA, DMHC, CMS standards Excellent communication and analytical skills CMCN or CPHQ certification Experience with health plan audits and delegation oversight
Job Description
Job Description
Utilization Management (UM) Manager – Managed Services Organization (MSO)
Location : Southern California (Hybrid / Onsite)
Employment Type : Full-time
About the Role
We are a growing Managed Services Organization (MSO) supporting physician groups across Southern California, seeking an experienced Utilization Management (UM) Manager to oversee daily UM operations. This role will lead prior authorization, concurrent review, and appeals functions while ensuring full compliance with NCQA, DMHC, and CMS standards.
Responsibilities
- Manage UM team operations and ensure timely, compliant authorizations
- Develop and implement UM policies and performance metrics
- Collaborate with Medical Directors on clinical determinations (InterQual / MCG)
- Lead delegation oversight and maintain audit-ready documentation
- Mentor staff and drive process improvement initiatives
Qualifications
Preferred
Benefits
Competitive salary, health insurance, 401(k), PTO, and career growth opportunities.
Apply today to join a fast-growing MSO dedicated to delivering quality, efficient, and compliant managed care services.
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Manager Utilization Management • Los Angeles, CA, US
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