Hiring: Associate Director of Utilization Management Company: Partnership HealthPlan of California Location: Fairfield, CA Job Posted Time: 2026-09-03 07:38:56 Employment Type: On-site Target Skills & Keywords : Compliance About the job Experience: •Demonstrated effective leadership and analytical skills. Effective oral and written communication skills. Excellent interpersonal skills. Required Skills: •Provides day-to-day direction to Utilization Managers and Supervisors to meet department goals and objectives. •Lead and oversee ensuring performance evaluations are completed appropriately in a timely manner. •Participates in the grievance process •Coordinates activities with Member Services, Claims, and Provider Relations departments to identify, track, and monitor quality of care issues and trends. •Lead and oversee establishing and maintaining reports that will support the efficacy of each Utilization Management (UM) activity and to produce a summary at least annually or upon request that includes statistical reports of activity, quality improvement activities, and utilization outcomes. •Provides oversight and monitoring of the medical claims review and appeals to ensure timely accurate response. •Provides direction and oversight to ensure efficient and appropriate collaboration between the Utilization Management staff and the delegated mental health provider and other internal and external organizations. •Ensures that all policies and procedures are updated at least annually or as needed and presented to appropriate committees for review. Qualifications: •Special Skills, Licenses and Interested candidates, please apply directly through the job posting on company's career page or try via AI auto apply on this platform. Don't miss this opportunity to join a forward-thinking team!