Prior Authorization UM Case Manager

UC San Diego Health is a Magnet designated organization, which is a prestigious recognition that applies to only 10% of all U.S. hospitals. Magnet is the “gold standard” for nursing excellence and is based on strengths in five key areas, which include transformational leadership, structural empowerment, exemplary professional practice, new knowledge, innovation and improvements and empirical outcomes. UC San Diego Health has held its Magnet status since 2011. The Prior Authorization UM Case Manager is responsible for managing the prior authorization process for various medical services, procedures, and medications. This includes ensuring that requests meet established criteria and are processed efficiently while adhering to insurance policies and medical necessity guidelines. Additionally, this role involves coordinating with healthcare providers, insurance companies, and internal teams to facilitate appropriate care and manage authorization requests effectively.