Emergency Care Case Manager: Discharge & Utilization Leader

UC Davis Health; Sacramento (CA); On-site; USD 104,000 - 153,000; Full time

Benefits offered by this job

Health insurance

Paid time off

Job summary

UC Davis Health is seeking a Clinical Case Manager to coordinate utilization review and discharge planning for acutely ill patients. The role emphasizes clinical judgment, interdepartmental collaboration, and effective communication with providers, payors, and patients to ensure appropriate, cost-efficient care.

Responsibilities include completing utilization reviews, coordinating discharge plans, and obtaining necessary authorizations while maintaining data accuracy and confidentiality.

Qualifications

• Minimum of one year case management experience in discharge planning or utilization review.
• Knowledge of Medicare, Medi-Cal, and HMO legislation and third party payor contracts.
• Ability to assess medical necessity and determine appropriate services.
• Ability to maintain confidentiality and professional communication.

Responsibilities

• Utilization review and case finding.
• Coordination and implementation of discharge plan.
• Communication, coordination and documentation.
• Secure authorization for care and reimbursement for hospital and physician.
• Denials and appeals management.
• Quality and education.

Skills

Clinical judgement

Communication skills

Discharge planning

Utilization Review

Education

Bachelor of Science in Nursing (BSN)

Job description

UC Davis Health is seeking a Clinical Case Manager to coordinate utilization review and discharge planning for acutely ill patients. The role emphasizes clinical judgment, interdepartmental collaboration, and effective communication with providers, payors, and patients to ensure appropriate, cost-efficient care.

Responsibilities include completing utilization reviews, coordinating discharge plans, and obtaining necessary authorizations while maintaining data accuracy and confidentiality.