RN Case Manager - case management - Days - PT - Irvine

UCI Health Case Manager

UCI Health is one of California's largest academic health systems and the clinical enterprise of the University of California, Irvine. Established on July 1, 1976, UCI Health has grown into a 1,461-bed health system that includes UCI Health - Orange, UCI Health - Irvine, four Community Network hospitals and a growing network of ambulatory care centers across Orange and Los Angeles counties. As Orange County's only academic health systems, UCI Health is home to the only National Cancer Institute-designated comprehensive cancer center based in the county, the region's only American College of Surgeons-verified Level I adult and Level II pediatric trauma center, American College of Emergency Physicians Gold Level 1 Geriatric Emergency Department and a nationally recognized regional burn center verified by the American Burn Association. Powered by UC Irvine, UCI Health serves 5.6 million people across Orange County, western Riverside County and southeast Los Angeles County through excellence in patient care, research and medical education.

Your Role on the Team

Position Summary: Incumbent is responsible for a high level assessment and reassessment process for the patient/family to set priorities, plan, organize, and implement care that is goal-directed toward self-care outcomes. Collaborates with an interdisciplinary approach to care facilitation to promote and coordinate the delivery of high quality, individualized, safe and cost-effective patient care, and transitions of care. Advocates for patient self-determination and choice. Practices cultural competence in evaluations and planning with awareness and respect for patient and family diversity. Monitors and coordinates resource utilization throughout the health system and evaluates services provided. Performs the appropriate utilization review functions utilizing medical staff-approved decision support criteria (InterQual Intensity of Service, Severity of Illness criteria). Concurrently intervenes to enhance patient quality outcomes where appropriate. Ensures clinical information in the medical record is clear and complete reflecting the patient's true severity of illness through interfacing with physicians to improve the overall quality of the clinical documentation.

What It Takes to be Successful

Required Qualifications: Must possess the skill, knowledge, and ability essential to the successful performance of assigned duties Must possess complete understanding of acuity levels for specific patient population Must demonstrate customer service skills appropriate to the job Minimum 5 years of clinical experience and 1 year of previous Case Management experience or a UCI employee who meets the clinical requirements and has a BSN. Familiarity of Joint Commission, CMS, CDPH and CCS requirements Excellent written and verbal communication skills in English Current RN License Computer literacy and proficiency All external candidates must have a Bachelor of Science in Nursing Ability to manage multiple concurrent projects and maintain a work pace appropriate to the workload Ability to facilitate and lead interdisciplinary rounds Ability to establish and maintain effective working relationships across the Health System Preferred Qualifications: Knowledge of University policies and procedures Knowledge of California Children's Services benefits authorization process (CCS) CCM, ACM or Case Management credentialing Bilingual skills