The Clinical Case Management department has the responsibility of hospital-wide Utilization Review and Discharge Planning, TAR, SDI Application Assistance and Transfer Center.
Job Summary Final Filing Date : 06/11/2022 Salary Range : $75.75 Salary Frequency : Hourly Appointment Type : Per Diem Percentage of Time : Variable Shift Hour : Variable Location : Medical Records Building City : Sacramento Union Representation : Yes Benefits Eligible : No
THIS IS NOT AN H1- B OPPORTUNITY
Responsibilities The purpose of the Clinical Case Manager is to 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 the utilization management, care facilitation and discharge planning functions. In addition, the Clinical Case Manager helps drive change by identifying areas where performance management is needed. This position is accountable for a designated patient caseload and plans effectively in order to meet patient needs, manage the length of stay and create a safe discharge plan. Facilitation of the collaborative management of patient care across the continuum, completing utilization review around LOC and authorization concerns, and intervening as necessary to remove barriers to timely and efficient care delivery and reimbursement.
Current RN license.
Graduation from an Accredited School of Nursing, BSN for internal/external candidates and per diem conversions preferred.
Minimum of 3 years recent experience in an acute care setting.
Current working knowledge of discharge planning, utilization management, case management, performance improvement and managed care reimbursement.
Knowledge of: Medicare, MediCal, and HMO legislation; MI county contracts; third party payor contracts; Title XXII; the Joint Commission; and Lumetra criteria.
Knowledge of professional and ethical standards related to Clinical Case Management such as the Nursing Practice Act, the Codes of Ethics from the American Nurses Association and the Standards of Practice & Scope of Services by the American Case Management Association.
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.
Excellent interpersonal and communication (verbal and written) skills.
Special Requirements Verification of licensure will be required at time of the appointment. Must be able to work variable schedule as needed. This position may be subject to a criminal background investigation, drug screen, Live Scan fingerprinting, medical evaluation clearance, and functional capacity assessment.
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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