RN Case Manager - Utilization Review Job at UCLA Health, Los Angeles, CA

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  • UCLA Health
  • Los Angeles, CA

Job Description

Using your advanced practice nursing skills, you will be responsible for assessing and coordinating care for a diverse group of patients. This in-patient utilization review case manager position will work on-site at our UCLA Ronald Reagan Medical Center on our CARD team.

You will collaborate and consult with a multi-disciplinary health care team as well as with patients and their families to ensure safe and effective coordination of care. In this role you will perform utilization review while assuring the delivery of concurrent and post-hospital care. We’re also looking to you to help drive performance improvement efforts.

Qualifications

We’re seeking a self-directed, creative problem solver with a:

  • BSN or MSN (ASN accepted for current UCLA Health Nursing staff)
  • CA RN License and BLS certification 
  • Recent experience in case management, utilization management and discharge planning 
  • Minimum of three years of acute hospital experience; or the equivalent of education and experience
  • Strong leadership abilities
  • Systems planning and patient care management experience in a high-volume work environment
  • Excellent communication, interpersonal, organizational and analytical skills
  • Ability to work effectively and collaboratively with interdisciplinary teamsKnowledge of a large university teaching hospitals
  • Experience preferred in Utilization Review (UR) for Medicare and Commercial/HMO payors; UR focused on Admission, Concurrent, and retrospective admission encounters.

Job Tags

Holiday work, Shift work,

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