Nursing Jobs in Laguna Niguel, CA
$91,640.44 - $117,605.23 / year
Supervisor – Inpatient Case Management (San Diego) Department: HS - ICM Employment Type: Full Time Location: 600 City Parkway West 10th Floor, Orange, CA 92868 Reporting To: Kylie Perine Compensation: $91,640 - $117,605 / year Description The Supervisor, Inpatient Case Management is responsible for leading and overseeing the daily operations of the inpatient case management team in the San Diego market. This role ensures timely, compliant, and high-quality utilization management, care coordination, and documentation while serving as a clinical and operational resource to staff, providers, and Medical Directors. The Supervisor plays a key role in driving consistency, productivity, and alignment with Astrana Health policies, payer requirements, and regulatory standards. What You'll Do Provide day-to-day supervision, coaching, and support to inpatient case managers Ensure timely completion of utilization review, authorizations, and documentation in accordance with policy and payer requirements Monitor team productivity, quality, and compliance with established workflows and turnaround times Serve as a clinical resource for complex cases, transfers, denials, and medical necessity reviews Collaborate daily with Medical Directors, hospitalists, and facility partners regarding bed days, level of care, and skilled admissions Escalate and help resolve barriers to care, discharge delays, and provider issues Support auditing, reporting, and continuous improvement initiatives related to quality and performance Assist with onboarding, training, and development of inpatient case management staff Ensure appropriate use of benefit guidelines, contracted providers, and payer rules Promote a culture of accountability, teamwork, and high-quality member care Miscellaneous responsibilities as directed by leadership Qualifications Active, unrestricted RN license (required) Minimum 3–5 years of inpatient case management or utilization management experience Prior supervisory or lead experience strongly preferred Strong working knowledge of medical necessity criteria, benefit guidelines, and payer requirements Experience collaborating with physicians, hospitalists, and Medical Directors Ability to interpret clinical documentation and apply appropriate level-of-care determinations Strong organizational, communication, and problem-solving skills Comfortable managing performance, productivity, and quality metrics Proficient with case management systems and electronic medical records Ability to work in a fast-paced, high-accountability environment Other duties as assigned Environmental Job Requirements and Working Conditions This is mostly a remote position. The home office is located at 600 City Parkway West, Orange County, CA 92868. This position does require traveling to partnered hospitals located in San Diego, CA. Staff should be flexible traveling based on business needs. The national target pay range for this role is $91,640.44 - $117,605.23. Actual compensation will be determined based on geographic location (current or future), experience, and other job-related factors. Astrana Health is proud to be an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at humanresourcesdept@astranahealth.com to request an accommodation. Additional Information: The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change. 
