Case Manager - Utilization Management SAT​/SUN shifts - PT

Position: Case Manager - Utilization Management - Days(SAT/SUN 10 hour shifts) - PT
Who We Are UCI Health is the clinical enterprise of the University of California, Irvine, and the only academic health system based in Orange County. UCI Health is comprised of its main campus, UCI Medical Center, a 459-bed, acute care hospital in in Orange, Calif., four hospitals and affiliated physicians of the UCI Health Community Network in Orange and Los Angeles counties and ambulatory care centers across the region.

Listed among America's Best Hospitals by U.S. News & World Report for 23 consecutive years, UCI Medical Center provides tertiary and qua ternary care and is home to Orange County's only National Cancer Institute-designated comprehensive cancer center, high-risk perinatal/neonatal program and American College of Surgeons-verified Level I adult and Level II pediatric trauma center, gold level 1 geriatric emergency department and regional burn center.

UCI Health serves a region of nearly 4 million people in Orange County, western Riverside County and southeast Los Angeles County. To learn more about UCI Health, visit (Use the "Apply for this Job" box below). 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 (Inter Qual 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.

Knowledge of standard office equipment (i.e., calculator, fax, photocopier) and personal computer and computer software skills (i.e., MS Windows, Excel, Access, Word, PowerPoint, internet, e-mail). Windows computer skills including proficient use of keyboarding, use of mouse or keys for functions such as selecting items, use of drop-down menus, scroll bars, opening folders, copying and similar operations required upon employment or within the 1st two weeks of employment to perform the essential functions of the job 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 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 Bilingual skills Total Rewards We offer a wealth of benefits to make working at UCI even more rewarding. These benefits may include medical insurance, sick and vacation time, retirement savings plans, and access to a number of discounts and perks. Please utilize the links listed here to learn more about our…