The Clinical Case Management department has the responsibility of hospital-wide Utilization Review and Discharge Planning, TAR (Treatment Authorization Request) and Transfer Center.
Job Summary Final Filing Date : 12/05/2022 Salary Range : $63.98 - $93.72 Salary Frequency : Hourly Appointment Type : Career Percentage of Time : 100% Number of Positions : Multiple
Shift Hour : 8:30-5:00 pm, M-F, Rotating Weekends and Holidays.
Location : Medical Records Building City : Sacramento Union Representation : Yes Benefits Eligible : Yes
We offer exceptional employment benefits including medical, dental, and vision plans, generous paid vacations and holidays, excellent retirement savings and investment plans, continuing education, and reduced fee and scholarship programs.
THIS IS NOT AN H1- B OPPORTUNITY.
Responsibilities The Clinical Case Manager will support the interdisciplinary team in facilitating patient care, with the underlying objective of enhancing the quality of clinical outcomes and patient satisfaction while managing the cost of care and providing timely and accurate information to payors. The role integrates and coordinates utilization management, care facilitation and discharge planning functions. This position helps drive change by identifying areas where performance improvement is needed.
Current California RN license.
Graduation from an Accredited School of Nursing, BSN preferred.
At least 1 year of recent experience in Case Management either Utilization Review and Discharge Planning.
Licensed RN with current working work experience in discharge planning, utilization review management.
Knowledge of Medicare, MediCal, and HMO legislation; third party payor contracts; Title XXII; the Joint Commission.
Demonstrated knowledge of how these programs/regulations affect the functions and role of the department.
Demonstrates the ability to incorporate them into departmental systems/processes. Knowledge of professional and ethical standards related to Clinical Case Management such as the Nursing Practice Ace, the Codes of Ethics from the American Nurses Association and the Standards of Practice & Scope of Services by the American Case Management Association.
Ability to read and comprehend English text and medical terminology; knowledge of medical and nursing treatment plans, levels of care, and area resources; skill in assessing the appropriateness of medical admissions and continued stay.
Skill to perform in-depth chart analysis to provide accurate information in a concise, informative manner, identify/analyze problems or issues related to areas of responsibility, developing an appropriate plan, and considering medical needs and resources available.
Ability to organize and direct varied health care team professionals in a manner that establishes a good rapport and professional working relationship.
Ability to work efficiently and independently, maintaining a calm manner while under pressure. Ability to organize work to accommodate special projects, deadlines and priorities; ability to be both flexible and adaptable in order to coordinate multiple variables and to respond to the need of a multi-faceted work area.
Possess clinical skills and knowledge base to assess and refer to discharge planning, possible needs for care necessary to meet patient's needs on discharge.
Understands the need to utilize discretion and maintain confidentiality when discussing patient matters.
Successfully applies interpersonal communication skills in areas such as conflict management.
Special Requirements This position may be subject to a criminal background investigation, drug screen, Live Scan fingerprinting, medical evaluation clearance, and functional capacity assessment. Verification of licensure will be required at time of the appointment.
The University of California has implemented a SARS-CoV-2 (COVID-19) Vaccination Program SARS-CoV-2 Vaccination Policy (ucop.edu) covering all employees. To be compliant with the policy, employees must submit proof of vaccination or a University-approved exception or deferral.
EEO The University of California is an Equal Opportunity/Affirmative Action Employer advancing inclusive excellence. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age, protected veteran status, or other protected categories covered by the UC nondiscrimination policy.
The University of California is an Equal Opportunity/Affirmative Action Employer advancing inclusive excellence. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age, protected veteran status, or other protected categories covered by the UC nondiscrimination policy.
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UC Davis is the home of the Aggies — go-getters, change makers and problem solvers who make their mark at one of the top public universities in the United States. Since we first opened in 1908, we’ve been known for standout academics, sustainability and Aggie Pride as well as valuing the Northern California lifestyle. These themes are woven into our 100-plus-year history and our reputation for solving problems related to food, health, the environment and society.Our 5,300-acre campus is in the city of Davis, a vibrant college town of about 68,000 located in Yolo County. The state capital is 20 minutes away, and world-class destinations such as the San Francisco Bay Area, Lake Tahoe and the Napa Valley are within a two-hour drive.
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