Utilization Management Lead; RN Regulatory Focus
Listed on 2026-10-18
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Nursing
Charge Nurse, Director of Nursing
Communityplans is seeking a Manager of Utilization Management in California to oversee UM functions, develop policies, and monitor quality. The role supervises the UM Supervisor and ensures compliance with DHCS, CMS, DMHC, NCQA standards and regulatory requirements.
The position requires RN licensure in California, 2+ years supervisory experience in managed care, and strong knowledge of UM processes. Proficiency with Outlook, Word, Excel and case management software is essential.
We are seeking a motivated Utilization Management Lead (RN) — Regulatory Focus to join Communityplans in California, MO, United States.
All applications are reviewed carefully by our team.
The position is based in California, MO, United States.
This opportunity is part of our work in Management & Operations.
The advertised compensation is 95..
We aim to respond to suitable candidates as soon as possible.
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