(RN) Prior Authorization UM Case Manager - Hybrid - 141189

UC San Diego Health; San Diego (CA); Hybrid; 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

Payroll Title

CASE MGR EX CEH

Department

PHSO - CLINICAL OPERATIONS

Hiring Pay Scale

$161,172 - $212,558 / Year

Worksite

La Jolla

Appointment Type

Career

Appointment Percent

100%

Union

HX Contract

Total Openings

1

Work Schedule

Days, 8-Hour Shift, Monday-Friday

#141189 Care Connections Hub RN CM – Hybrid

Filing Deadline

Wed 9/30/2026

UC San Diego values and welcomes people from all backgrounds. If you are interested in being part of our team, possess the needed licensure and certifications, and feel that you have most of the qualifications and/or transferable skills for a job opening, we strongly encourage you to apply.

UCSD Layoff from Career Appointment: Apply by 09/21/2026 for consideration with preference for rehire. All layoff applicants should contact their Employment Advisor.

Reassignment Applicants: Eligible Reassignment clients should contact their Disability Counselor for assistance.

This position may work a hybrid schedule, which includes a combination of working both onsite at Greenwich Drive and remote. Current department requirement is on-site one day per week.

Description

UC San Diego Health is proud to be a four-time Magnet-designated organization and has now earned Magnet with Distinction from the American Nurses Credentialing Center (ANCC). Magnet is the gold standard for nursing excellence, achieved by only about 10% of hospitals worldwide. Magnet with Distinction is awarded to the highest-performing Magnet organizations, with only a select few earning this prestigious honor. This recognition reflects our commitment to transformational leadership, professional nursing excellence, innovation, exceptional patient outcomes, and an empowering practice environment where nurses thrive.

The Population Health Care Connections Hub consists of a team of RN with case management experience who perform telephonic outreach to high-risk patients to help prevent avoidable events. Most of these calls are for patients who discharge from an acute inpatient stay and /or it could be for internal provider referrals for our patients who may need additional help while at home. This role requires someone who has strong initiative, critical thinking skills, and previous case management experience. Previous experience with EPIC and Care Port a plus. Knowledge of community resources is critical to help patients with their care coordination needs. A strong understanding of payers, community resources, DME, HH, and skilled nursing facilities in the area is critical to being successful in this role

While not required, a cover letter is highly recommended when applying to this position.

Minimum 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. Strong preference for experience in telephonic outreach with high-risk patient populations and working with insurance companies.
• Proficiency in Information Systems and computer programs such as Word and Excel.
• Must possess excellent interpersonal and communication skills.
• Must be able to work within a team environment.

Preferred Qualifications

• BSN or Master's Degree.
• ACM and/or CCM certificate.
• Epic knowledge and experience.

SPECIAL CONDITIONS

• Must have access to high-speed internet when working remotely.
• Must be able to work various hours and locations based on business needs.
• Employment is subject to a criminal background check and a pre-employment physical.

Pay Transparency Act

Annual Full Pay Range: $161,173 - $212,558 (will be prorated if the appointment percentage is less than 100%)

Hourly Equivalent: $77.19 - $101.80

Factors in determining the appropriate compensation for a role includes experience, skills, knowledge, abilities, education, licensure and certifications, and other business and organizational needs. The Hiring Pay Scale referenced in the job posting is the budgeted salary or hourly range that the University reasonably expects to pay for this position. The Annual Full Pay Range may be broader than what the University anticipates to pay for this position, based on internal equity, budget, and collective bargaining agreements (when applicable).

If employed by the University of California, you will be required to comply with our Policy on Vaccination Programs, which may be amended or revised from time to time. Federal, state, or local public health directives may impose additional requirements.

If applicable, life-support certifications (BLS, NRP, ACLS, etc.) must include hands-on practice and in-person skills assessment; online-only certification is not acceptable.

UC San Diego Health is the only academic health system in the San Diego region, providing leading-edge care in patient care, biomedical research, education, and community service. Our facilities include two university hospitals, a National Cancer Institute-designated Comprehensive Cancer Center, Shiley Eye Institute, Sulpizio Cardiovascular Center, the only Burn Center in the county, and dozens of outpatient clinics. We invite you to join our team!

Applications/Resumes are accepted for current job openings only. For full consideration on any job, applications must be received prior to the initial closing date. If a job has an extended deadline, applications/resumes will be considered during the extension period; however, a job may be filled before the extended date is reached.

To foster the best possible working and learning environment, UC San Diego strives to cultivate a rich and diverse environment, inclusive and supportive of all students, faculty, staff and visitors. For more information, please visit UC San Diego Principles of Community.

The University of California is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age, protected veteran status, or other protected status under state or federal law.

For the University of California’s Anti-Discrimination Policy, please visit: https://policy.ucop.edu/doc/1001004/Anti-Discrimination

UC San Diego is a smoke and tobacco free environment. Please visit smokefree.ucsd.edu for more information.

UC San Diego Health maintains a marijuana and drug free environment. Employees may be subject to drug screening.

Misconduct Disclosure Requirement

As a condition of employment, the final candidate who accepts an offer of employment will be required to disclose if they have been subject to any final administrative or judicial decisions within the last seven years determining that they committed any misconduct; or have filed an appeal of a finding of substantiated misconduct with a previous employer.

• "Misconduct" means any violation of the policies governing employee conduct at the applicant’s previous place of employment, including, but not limited to, violations of policies prohibiting sexual harassment, sexual assault, or other forms of harassment, or discrimination, as defined by the employer. For reference, below are UC’s policies addressing some forms of misconduct:
• UC Sexual Violence and Sexual Harassment Policy
• UC Anti-Discrimination Policy
• Abusive Conduct in the Workplace