RN Case Manager – Telephonic Prior Authorization

UC San Diego Health; San Diego (CA); On-site; USD 161,000 - 213,000; Full time

Job summary

UC San Diego Health seeks an experienced RN case manager to support the Care Connections Hub. You will coordinate post-discharge care for high-risk patients, perform telephonic outreach, and collaborate with payers and community resources to optimize outcomes.

The role requires strong initiative, critical thinking, and prior RN CM experience with ED or inpatient settings; EPIC experience is a plus. Hybrid schedule with on-site presence as needed.

Qualifications

• Must be a graduate from an accredited school of Nursing.
• RN license issued by the State of California.
• Minimum two (2) years of recent RN experience in inpatient case management and recent ambulatory RN CM experience.
• Proven background in managing high-risk patients post-discharge; telephonic outreach preferred.
• Proficiency in information systems and Word/Excel.
• Excellent interpersonal and communication skills; able to work in a team.

Responsibilities

• Perform telephonic outreach to high-risk patients to prevent avoidable events.
• Coordinate care post-discharge with payers, community resources, DME, HH, and SNFs.
• Utilize EPIC and Care Port; assist with care coordination needs.

Skills

RN license

Inpatient case management

Ambulatory CM experience

Telephonic outreach

Information Systems

Word and Excel

Interpersonal skills

Team player

Education

Accredited nursing program graduate

BSN or higher

ACM certification

CCM certification

Tools

Epic

Job description

UC San Diego Health seeks an experienced RN case manager to support the Care Connections Hub. You will coordinate post-discharge care for high-risk patients, perform telephonic outreach, and collaborate with payers and community resources to optimize outcomes.

The role requires strong initiative, critical thinking, and prior RN CM experience with ED or inpatient settings; EPIC experience is a plus. Hybrid schedule with on-site presence as needed.