RN Utilization Manager (Hybrid)

Direct Hire + Hybrid! 100% Employer Paid Benefits! Professional Development/Tuition Reimbursement, look no further for your RN Utilization Manager Opportunity!

For a complete understanding of this opportunity, and what will be required to be a successful applicant, read on.

Job Title: RN Utilization Manager (Hybrid)

Location: Palm Springs, CA

Employment Type: Direct Hire

Schedule: M–F - 8AM–5PM

Salary: $123,968/yr

Overview:

We’re hiring an RN Referrals Manager/Utilization Manager to lead a high-volume referrals department. This is a newly established leadership role supporting referral processing, regulatory compliance, and performance management, with 11 direct reports plus offshore referral coordinators.

Key Responsibilities for RN Utilization Manager:

Provide daily oversight of the Referral Department (workflow, quality, turnaround times)

Ensure compliance with applicable regulatory and health plan requirements

Coach, train, and develop staff; monitor productivity and performance trends

Support audits (CMS/DMHC/DHCS/Health Plan) and corrective action plans

Serve as the clinical resource for referral processing and peer-to-peer coordination

Partner with medical leadership and senior directors to improve processes and documentation Required Qualifications for RN Utilization Manager:

Active California RN license

Bachelor’s Degree in Nursing (BSN) required (Master’s preferred)

3+ years RN experience in Utilization Review/Compliance Review/Acute Care/ER

3+ years in a Supervisory/Managerial role

Strong knowledge of clinical criteria and documentation standards; familiarity with diagnosis/procedure coding practices 100% Paid Benefits:

Medical insurance at no cost to employee (employer covered)

No-cost pharmacy benefit (employee)

Dental, Vision, EAP, Life/AD&D, LTD options

401(k) with company match; PTO (released after 90-day evaluation) Referral Bonus (MediQuest):

Referrals really pay off. Do you know someone in healthcare looking for work? Refer them to MediQuest and earn up to $500 per referral, depending on the type of position they accept.

No limit to the number of referrals you provide or the amount you can earn

Anyone can earn a referral bonus - not just MediQuest candidates About MediQuest:

MediQuest matches high-quality healthcare professionals with talented medical support staff. Our dedicated medical focus and expertise allow us to build collaborative partnerships with both clients and candidates, ultimately creating lasting value and delivering performance-based results in the constantly evolving healthcare industry. We have been connecting candidates with private practices, outpatient clinics, hospitals, independent physicians’ associations, medical billing services, urgent care, and healthcare administration since 1965. We know that it takes great people to make a great company.PandoLogic. xqrzhdi Keywords: Utilization Review Nurse, Location: Morongo Valley, CA - 92256

Remote working/work at home options are available for this role.

Full Time