UC Irvine Health
Manager, Case Management - FT Days - LOM
UC Irvine Health, Los Alamitos, California, us, 90721
UC Title: Mgr, Case Management FVRPosition Number:
41087592Reports to:
Dir, Case Management LOMWorking Title:
Mgr, Case Management FVRCost Center:
Case Management-LOM (423750)Bargaining Unit:
No Bargaining UnitFLSA:
ExemptDate Created:
5/03/2024Job Code:
009504Hours:
40Shift:
Not ApplicableFTE:
1Position Summary:The individual in this position supports the Director of Case Management (DCM) in the hospital utilization performance improvement and operational management of the Case Management Department in order to promote effective utilization of hospital resources, ensure process support appropriate reimbursement for services rendered, support efficient patient throughput, and ensure compliance with all state and federal regulations related to case management services. The individual's responsibilities include the following activities:Support the management of department operations to assure effective throughput and reimbursement for service provided.Support DCM in the implementation and oversight of the hospital Utilization Management Plan using data to drive hospital utilization performance improvement.Ensure medical necessity review processes are completed accurately and in compliance with CMS regulations and Tenet policy.Ensure timely and effective patient transition and planning to support efficient patient throughput.Implement and monitor processes to prevent payer disputes.Collaborate with physicians, office staff, and ancillary departments.Ensure compliance with state and federal regulations and TJC accreditation standards.Lead complex case review in DCM's absences.Assist DCM with onboarding of new employees and education of staff.Support coaching and performance management of staff with DCM.Other duties as assigned.Total Compensation:In addition to the salary range listed below, we offer a wealth of benefits to make working at UCI even more rewarding. These benefits may include medical insurance, sick and vacation time, retirement savings plans, and access to a number of discounts and perks.Required Qualifications:CA Licensed Registered Nurse. 3 Years Case Management/Utilization Review experience in acute care. Supervisory experience. Skills required include excellent organizational skills, excellent verbal and written communication skills, demonstrated problem solving skills, and computer literacy. Ability to establish and maintain effective working relationships across the Health System. Ability to maintain a work pace appropriate to the workload. Must demonstrate customer service skills appropriate to the job. Excellent written and verbal communication skills in English. Must possess the skill, knowledge and ability essential to the successful performance of assigned duties.Preferred Qualifications:Bachelor's degree preferred. CCM or ACM Certification. Knowledge of University and medical center organizations, policies, procedures and forms.Conditions of Employment:The University of California, Irvine (UCI) seeks to provide a safe and healthy environment for the entire UCI community. As part of this commitment, all applicants who accept an offer of employment must comply with the following conditions of employment:Background Check and Live ScanLegal Right to Work in the United StatesVaccination PoliciesSmoking and Tobacco PolicyDrug Free EnvironmentThe following additional conditions may apply, some of which are dependent upon business unit or job specific requirements.California Child Abuse and Neglect Reporting ActE-VerifyPre-Placement Health EvaluationClosing Statement:The University of California, Irvine is an Equal Opportunity/Affirmative Action Employer advancing inclusive excellence. 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 categories covered by the UC nondiscrimination policy.We are committed to attracting and retaining a diverse workforce along with honoring unique experiences, perspectives, and identities. Together, our community strives to create and maintain working and learning environments that are inclusive, equitable and welcoming.UCI provides reasonable accommodations for applicants with disabilities upon request. For more information, please contact UCI’s Employee Experience Center (EEC) at eec@uci.edu or at (949) 824-0500, Monday – Friday from 8:30 a.m. – 5:00 p.m.Physical, Mental, & Environmental Demands:To comply with the Rehabilitation Act of 1973 the essential physical, mental and environmental requirements for this job are listed below. These are requirements
normally expected
to perform
regular
job duties. Incumbent must be able to successfully perform all of the functions of the job with or without reasonable accommodation.
#J-18808-Ljbffr
41087592Reports to:
Dir, Case Management LOMWorking Title:
Mgr, Case Management FVRCost Center:
Case Management-LOM (423750)Bargaining Unit:
No Bargaining UnitFLSA:
ExemptDate Created:
5/03/2024Job Code:
009504Hours:
40Shift:
Not ApplicableFTE:
1Position Summary:The individual in this position supports the Director of Case Management (DCM) in the hospital utilization performance improvement and operational management of the Case Management Department in order to promote effective utilization of hospital resources, ensure process support appropriate reimbursement for services rendered, support efficient patient throughput, and ensure compliance with all state and federal regulations related to case management services. The individual's responsibilities include the following activities:Support the management of department operations to assure effective throughput and reimbursement for service provided.Support DCM in the implementation and oversight of the hospital Utilization Management Plan using data to drive hospital utilization performance improvement.Ensure medical necessity review processes are completed accurately and in compliance with CMS regulations and Tenet policy.Ensure timely and effective patient transition and planning to support efficient patient throughput.Implement and monitor processes to prevent payer disputes.Collaborate with physicians, office staff, and ancillary departments.Ensure compliance with state and federal regulations and TJC accreditation standards.Lead complex case review in DCM's absences.Assist DCM with onboarding of new employees and education of staff.Support coaching and performance management of staff with DCM.Other duties as assigned.Total Compensation:In addition to the salary range listed below, we offer a wealth of benefits to make working at UCI even more rewarding. These benefits may include medical insurance, sick and vacation time, retirement savings plans, and access to a number of discounts and perks.Required Qualifications:CA Licensed Registered Nurse. 3 Years Case Management/Utilization Review experience in acute care. Supervisory experience. Skills required include excellent organizational skills, excellent verbal and written communication skills, demonstrated problem solving skills, and computer literacy. Ability to establish and maintain effective working relationships across the Health System. Ability to maintain a work pace appropriate to the workload. Must demonstrate customer service skills appropriate to the job. Excellent written and verbal communication skills in English. Must possess the skill, knowledge and ability essential to the successful performance of assigned duties.Preferred Qualifications:Bachelor's degree preferred. CCM or ACM Certification. Knowledge of University and medical center organizations, policies, procedures and forms.Conditions of Employment:The University of California, Irvine (UCI) seeks to provide a safe and healthy environment for the entire UCI community. As part of this commitment, all applicants who accept an offer of employment must comply with the following conditions of employment:Background Check and Live ScanLegal Right to Work in the United StatesVaccination PoliciesSmoking and Tobacco PolicyDrug Free EnvironmentThe following additional conditions may apply, some of which are dependent upon business unit or job specific requirements.California Child Abuse and Neglect Reporting ActE-VerifyPre-Placement Health EvaluationClosing Statement:The University of California, Irvine is an Equal Opportunity/Affirmative Action Employer advancing inclusive excellence. 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 categories covered by the UC nondiscrimination policy.We are committed to attracting and retaining a diverse workforce along with honoring unique experiences, perspectives, and identities. Together, our community strives to create and maintain working and learning environments that are inclusive, equitable and welcoming.UCI provides reasonable accommodations for applicants with disabilities upon request. For more information, please contact UCI’s Employee Experience Center (EEC) at eec@uci.edu or at (949) 824-0500, Monday – Friday from 8:30 a.m. – 5:00 p.m.Physical, Mental, & Environmental Demands:To comply with the Rehabilitation Act of 1973 the essential physical, mental and environmental requirements for this job are listed below. These are requirements
normally expected
to perform
regular
job duties. Incumbent must be able to successfully perform all of the functions of the job with or without reasonable accommodation.
#J-18808-Ljbffr