UCI Health - Lakewood, CA
posted 3 days ago
About the position
The individual in this position is responsible for coordinating patient care activities to conform to evidence-based practice and/or regulatory/payor requirements. This position integrates functions typically considered to be case management, care coordination, and/or utilization management, and discharge planning assessment. Responsibilities include coordinating care, planning for discharge needs and arrangements, leading multidisciplinary discharge planning teams, assessing patients for discharge planning needs, reviewing utilization patterns, referring complex social issues to social work, managing concurrent denials, coordinating weekly Complex Case Review, collecting clinical process and outcomes data, communicating with patients and their families around the plan of care, assisting with physician documentation, arranging for patient education, and collaborating with physicians and ancillary departments.
Responsibilities
- Coordinating care
- Planning for discharge needs and arrangements
- Leading multidisciplinary discharge planning teams
- Assessing patients for discharge planning needs
- Reviewing utilization patterns
- Referring complex social issues to social work
- Managing concurrent denials
- Coordinating weekly Complex Case Review
- Collecting clinical process and outcomes data
- Communicating with patients and their families around plan of care
- Assisting with physician documentation
- Arranging for patient education
- Communicating and collaborating with physicians and ancillary departments
- Ensuring accuracy of patient demographic and insurance information
- Making appropriate referrals to other departments
Requirements
- Must possess the skill, knowledge and ability essential to the successful performance of assigned duties
- Must demonstrate customer service skills appropriate to the job
- Excellent written and verbal communication skills in English
- Ability to maintain a work pace appropriate to the workload
- Ability to establish and maintain effective working relationships across the Health System
- Mandatory: Current CA RN license
- Conversant knowledge and experience with case management, care coordination, and/or utilization review
- Demonstrate the ability in collaborating with physicians
- Ability to lead and coordinate activities of a diverse group of people
Nice-to-haves
- Knowledge of University and medical center organizations, policies, procedures and forms
Benefits
- Medical insurance
- Sick and vacation time
- Retirement savings plans
- Access to a number of discounts and perks
