Job Description & Salary RangeUC Title: Case Manager EXPosition Number: 10003958Reports to: Case Manager, SupervisorWorking Title: Case ManagerCost Center: Case Management (8727)Bargaining Unit: HXFLSA: ExemptJob Code: 7870Date Created: 10/26/2016Shift: Day ShiftHours: 40.00
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.
Rate Minimum $95,985.36 Maximum $114,714.72
Required Qualifications: Ability to establish and maintain effective working relationships across the HealthSystemAbility to facilitate and lead interdisciplinary roundsAbility to manage multiple concurrent projects and maintain a work pace appropriate to the workloadAll external candidates must have a Bachelor of Science in Nursing Computer literacy and proficiencyCurrent Licensed Registered Nurse, Social Worker (MSW or LCSW), or Licensed Healthcare Therapist professional that allows for independent assessments as permitted within the scope of practice of the disciplineExcellent written and verbal communication skills in EnglishFamiliarity of Joint Commission, CMS, CDPH and CCS requirementsMinimum 5 years of clinical experience and 1 year of previous Case Management experience or completion of the 1 year UC Irvine Medical Center Case Management Mentorship ProgramMust demonstrate customer service skills appropriate to the jobMust possess complete understanding of acuity levels for specific patient populationMust possess the skill, knowledge, and ability essential to the successful performance of assigned duties
Preferred Qualifications: Bilingual skillsCCM, ACM or Case Management credentialingKnowledge of California Children's Services benefits authorization process (CCS)Knowledge of University policies and procedures
Physical, Mental & Environmental Demands:To comply with the Rehabilitation Act of 1973 the essential physical, mental and environmental requirements for this job are listed below. These are requirements normally expected to perform regular job duties. Incumbent must be able to successfully perform all of the functions of the job with or without reasonable accommodation.
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