Utilization Management Manager

Akido Labs, Inc.

Chino, CA, United States
$70,000—$90,000 usd py
On-site
Utilization management operations
Regulatory compliance
Health plan relationships
Akido Labs, Inc. is seeking a Utilization Management Manager to oversee operations across multiple IPAs in Southern California. This role focuses on ensuring regulatory compliance and operational excellence while leading a team to improve workflows and health plan relationships

Job Summary

  • Lead and oversee Utilization Management operations across multiple IPAs supported by our MSO in Southern California.
  • Serve as the primary operational point of contact for contracted health plans while leading a team of 5–10 professionals.
  • Partner with executive leadership to identify process improvements, system enhancements, and automation opportunities to scale MSO operations.

Matching Summary

Match Score: 85

Akido Labs, Inc. is seeking a Utilization Management Manager to oversee operations across multiple IPAs in Southern California. This role focuses on ensuring regulatory compliance and operational excellence while leading a team to improve workflows and health plan relationships.

Salary

$70,000—$90,000 USD

Skills & Requirements

Must-have

  • Utilization Management operations
  • regulatory compliance
  • health plan relationships
  • AI Operations team partnership
  • authorization workflows
  • medical necessity review

Nice-to-have

  • scalable, high-performing workflows
  • creative automations
  • measurable improvements

Key Requirements

  • Minimum 10 years of experience in Utilization Management, Managed Care, or IPA/MSO operations
  • Deep expertise in regulatory requirements governing delegated UM functions in California
  • Experience overseeing health plan audits, delegated oversight reporting, and ODAG logs
  • Demonstrated experience managing teams in a multi-IPA or delegated risk environment
  • Strong knowledge of authorization workflows, and medical necessity criteria
  • MCG Certified
  • Experience serving as a primary operational contact for health plans
  • Proficiency in platforms such as EZCap, EZNet, EMR systems, reporting tools, and health plan portals

Work Rights

Not specified

Tailored Resume

Cover Letter