RN Case Manager: Care Coordination Leader

UC Irvine; Los Alamitos (CA); On-site; USD 85,000 - 100,000; Full time

Job summary

UCI Health in Orange County, part of the University of California, Irvine, seeks a Case Manager to coordinate quality care across the continuum for diverse patient populations. You will lead discharge planning, utilization management, and cross-functional collaboration with the Health System to improve patient outcomes while navigating managed care and regulatory guidelines in a fast-paced environment.

We value dedication to patient-centered care, evidence-based practice, and strong written and

Qualifications

• Valid, current California Nursing License.
• Minimum of 1 year discharge planning experience.
• Working knowledge of managed care and capitation operations.
• Working knowledge of Intequal IS-SI Criteria.
• Knowledge of Medicare, Medi-Cal, NCQA, Heidis, and related criteria.

Responsibilities

• Coordinate timely quality health care services across the continuum of care.
• Initiate and implement utilization/resource management and discharge planning.
• Support optimal patient care outcomes through the continuum of care.

Skills

Customer service skills

English communication

Interpersonal collaboration

Discharge planning

Managed care knowledge

Quality/Case Management standards

Job description

UCI Health in Orange County, part of the University of California, Irvine, seeks a Case Manager to coordinate quality care across the continuum for diverse patient populations. You will lead discharge planning, utilization management, and cross-functional collaboration with the Health System to improve patient outcomes while navigating managed care and regulatory guidelines in a fast-paced environment.

We value dedication to patient-centered care, evidence-based practice, and strong written and