Registered Nurse Case Manager I

2 weeks ago


Placentia, California, United States University Of California Irvine Full time
About Us

University of California, Irvine Health is a premier academic health system located in Orange County, recognized for its excellence in patient care and innovative medical practices. Our network includes a 459-bed acute care hospital and several affiliated facilities, providing comprehensive health services to a diverse population.

Your Role

Position Overview:

The RN Case Manager plays a crucial role in coordinating patient care across various stages of treatment. This position is dedicated to optimizing health outcomes through effective resource management, ensuring patients receive the necessary care while respecting their autonomy. Responsibilities include:
  • Conducting utilization management to uphold medical necessity and prevent service denials.
  • Facilitating transitions of care to enhance patient satisfaction and minimize readmissions.
  • Coordinating care to ensure timely and appropriate treatment sequences.
  • Adhering to regulatory standards and organizational policies.
  • Providing education to healthcare providers, patients, and their families.
Key responsibilities entail: a) performing medical necessity evaluations, b) coordinating patient care, c) assessing transition needs, d) implementing transition plans, e) leading multidisciplinary care discussions, f) managing concurrent care disputes, g) referring patients to additional services, h) communicating care plans to patients and families, i) collaborating with healthcare teams, j) overseeing complex case reviews, k) ensuring patient education for post-acute needs, l) maintaining accurate documentation, m) tracking patient demographics and insurance details, n) identifying avoidable days, o) reporting utilization trends, and p) fulfilling other assigned duties.

Qualifications for Success

Compensation and Benefits:

We offer a comprehensive benefits package designed to enhance your experience at UCI Health, including medical coverage, paid time off, retirement plans, and various employee discounts.

Required Qualifications:
  • Active Registered Nurse license with a minimum of two years of experience in acute care settings. A Bachelor of Science in Nursing (BSN) is preferred, along with certification as an Accredited Case Manager (ACM).
  • 1-2 years of prior case management experience.
  • Strong organizational skills, excellent communication abilities, and proficiency in leading diverse teams in a dynamic environment.
  • Critical thinking and problem-solving skills, along with computer literacy.
  • Ability to foster effective working relationships across the healthcare system.
  • Commitment to maintaining a pace suitable for workload demands.
  • Demonstrated customer service skills relevant to the role.
Preferred Qualifications:
  • Familiarity with the policies and procedures of university and healthcare organizations.
Employment Conditions:

UCI is dedicated to ensuring a safe workplace for all employees. Candidates who accept an offer of employment must comply with various conditions, including:
  • Background checks and verification of work eligibility.
  • Compliance with vaccination policies.
  • Adherence to a drug-free workplace.
Additional conditions may apply based on specific job requirements.

Commitment to Diversity

UCI is an Equal Opportunity/Affirmative Action Employer, welcoming applicants from diverse backgrounds and experiences. We strive to create an inclusive environment that values unique perspectives and identities.

Work Authorization

Proof of work authorization is required.

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