Your Role on the Team

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.

What It Takes to be Successful

Required Qualifications:

Must possess the skill, knowledge, and ability essential to the successful performance of assigned duties

Must possess complete understanding of acuity levels for specific patient population

Must demonstrate customer service skills appropriate to the job

Minimum 5 years of clinical experience and 1 year of previous Case Management experience or a UCI employee who meets the clinical requirements and has a BSN.

Familiarity of Joint Commission, CMS, CDPH and CCS requirements

Excellent written and verbal communication skills in English

Current RN License

Computer literacy and proficiency

All external candidates must have a Bachelor of Science in Nursing

Ability to manage multiple concurrent projects and maintain a work pace appropriate to the workload

Ability to facilitate and lead interdisciplinary rounds

Ability to establish and maintain effective working relationships across the Health System

Preferred Qualifications:

Knowledge of University policies and procedures

Knowledge of California Children's Services benefits authorization process (CCS)

CCM, ACM or Case Management credentialing

Bilingual skills

Total Rewards

We offer a wealth of benefits to make working at UCI even more rewarding. These benefits may include medical insurance, sick and vacation time, retirement savings plans, and access to a number of discounts and perks. Please utilize the links listed here to learn more about our compensation practices and benefits.