Case Manager

4 days ago


Orange, California, United States UCI Medical Center Full time
Job Summary

We are seeking a highly skilled Case Manager to join our team at UCI Medical Center. As a Case Manager, you will play a critical role in providing psychosocial support to individuals, families, and groups affected by chronic, acute, or terminal illnesses.

Key Responsibilities
  • Admission and Review Process: Perform admission, concurrent, and retrospective reviews on all patients to ensure accurate status and level of care determination.
  • Pre-Certifications and Authorizations: Obtain and document pre-certifications/authorizations for all admissions, surgeries, and procedures, adhering to Medicare guidelines.
  • Utilization Review: Follow Medicare guidelines regarding utilization review, ensuring that treatment plans are implemented, re-evaluated, and updated daily.
  • Patient Advocacy: Act as an advocate for patients and families, facilitating effective communication between treatment team members and coordinating meetings with families and treatment teams.
  • Post-Acute Care Services: Facilitate arrangement of post-acute care services, ensuring seamless transitions for patients.
  • Quality and Risk Management: Identify, document, and report quality, cost, and risk variances related to patient plans of care.
Requirements
  • Education and Experience: Graduate of an accredited school of nursing, with a minimum of one year of current Case Manager experience in a healthcare facility.
  • Credentials: Evidence of current AHA BLS credential mandatory.
Benefits
  • Competitive Salary: Earn a competitive salary, with opportunities for growth and advancement.
  • Comprehensive Benefits Package: Enjoy a comprehensive benefits package, including health, dental, and vision insurance, as well as retirement savings options.
  • Professional Development: Participate in ongoing professional development opportunities, enhancing your skills and knowledge in case management and patient advocacy.


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