Experience:
No experience
Employment Type:
Intern/Co-op
Posted:
9/11/2017
Job Category:
Nursing
Industry:
Health Care & Medicine
RN - Case Manager - Utilization Mgmt/Rev Cycle
(This job is no longer available)
UCLA Health | Los Angeles, CA
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Job Description

Job Duties
The Case Manager is responsible for utilizing advanced nursing skills in the assessment and planning of clinical care for an identified group of patients. Collaborates with the Attending, Resident, and Intern medical staff as well as Resource Planning, Nursing, ancillary, professional, and technical staff to coordinate the delivery of high quality, individualized, cost-effective patient care. Performs appropriate Utilization Review functions utilizing approved Intensity of Service, Severity of Illness criteria. Coordinates utilization management and evaluates services provided. Oversight responsibilities of the Resource Planner includes delegation and supervision of daily work assignments, education of the discharge planning process, and identification of barriers to discharge/transfers. Concurrently intervenes to enhance patient quality outcomes where appropriate. Brings support to the performance improvement process by comprehensive analysis of patterns and trends. Acts as a consultant to the Care Coordination team, clinical team, and other departments.

Job Qualifications
California RN license and BSN are required. MSN preferred. Minimum of three years of acute hospital experience; or the equivalent of education and experience. Recent experience in case management, utilization management, or discharge planning. Team leading or management experience. Self-directed, assertive and creative in problem solving, systems planning and patient care management in a high volume work environment. Demonstrates resourcefulness, effective written and oral communication, diplomacy, organizational, and analytical skills. Ability to work effectively and collaboratively with interdisciplinary teams. Basic working knowledge of a large University teaching hospital; its purpose and functions.

About UCLA Health

For more than half a century, UCLA Health  has provided the best in healthcare and the latest in medical technology to thepeople of Los Angeles and throughout the world. Today we are one of the most comprehensive and advanced healthcare systems in existence. We are comprised of Ronald Reagan UCLA Medical Center, UCLA Medical Center, Santa Monica, Resnick Neuropsychiatric Hospital at UCLA, Mattel Children’s Hospital UCLA, and the UCLA Medical Group, with offices throughout the region.

Ronald Reagan UCLA Medical Center is consistently ranked by U.S.News & World Report as one of the top five hospitals in the nation and the best medical center in the western United States. The doctors, scientists and caregivers of UCLA are leaders in their fields. Every day, they perform pioneering work across an astounding range of disciplines, from organ transplantation and cardiac surgery to neurosurgery and cancer treatment. Year after year, our people have achieved medical breakthroughs and earned the highest industry honors. And we’re just getting started.

The dedicated professionals of UCLA Health are committed to healing humankind, one patient at a time, by improving health, alleviating suffering, and delivering acts of kindness on a daily basis.