Job Description

General Information

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Work Location: Los Angeles, CA, USA
Onsite or Remote
Flexible Hybrid
Work Schedule
1:00PM-10:00PM Wed/Thur/Fri; 8:00AM-5:00PM Saturday, Sunday and Holidays
Posted Date
04/07/2026
Salary Range $35.47 - 48.82 Hourly
Employment Type
2 - Staff: Career
Duration
Indefinite
Job #
29647

Primary Duties and Responsibilities

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Take on a vital role within a leading health organization. Help ensure smooth and efficient case management processes to support quality care. Take your expertise to the next level. You can do all this and more at UCLA Health.

Under the direction of the Utilization Management, Assistant Director, you will play a key role in processing and managing authorization requests and care coordination support. You will:

• Receive urgent, routine, pre-service, and retro authorization requests
• Process referrals and authorizations following established procedures within the medical group utilization department
• Prepare and process referrals according to Delegation of Financial Responsibility (DOFR), UCLA Medical Group Medical Guidelines, and health plan contracts
• Identify and prepare necessary documents for the next level of review
• Maintain and prepare specific reports and manage computer applications and logs
• Conduct urgent care coordination needs for complex and high risk population
• Care managed, monitor, coordinate needs of members/patients followed by Case Management
• Work directly with a nurse, ICM team lead and Medical Director.
• Review pending claims for approval or denial

Salary Range: $35.47 - $ 48.82/Hourly

Job Qualifications

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• High school diploma, GED, or equivalent experience
• Experience working in a Managed Care environment, highly desired
• Experience processing ambulatory managed care referrals, preferred
• Proficient computer skills with working knowledge of Microsoft Excel and Word
• Ability to operate a variety of office equipment, including computers, printers, copiers, fax machines, scanners, and mailing equipment
• Ability to multi-task, work with frequent interruptions, and meet deadlines
• Strong attention to detail, organization, and ability to follow directions
• Clear and concise communication skills, both written and verbal
• Familiarity with Vodavi phone system
• Ability to lift up to 25 pounds
• Willing to work on the following schedule: Wednesday through Friday 1:00pm -10:00pm and Saturday, Sundays and Holidays from 8:00am - 5:00pm

As a condition of employment, the final candidate who accepts an offer of employment will be required to disclose if they have been subject to any final administrative or judicial decisions within the last seven years determining that they committed any misconduct; or have filed an appeal of a finding of substantiated misconduct with a previous employer.