(RN) Care Manager - La Jolla - 129160

UC San Diego Health is a Magnet designated organization, which is a prestigious recognition that applies to only 10% of all U.S. hospitals. Magnet is the "gold standard" for nursing excellence and is based on strengths in five key areas, which include transformational leadership, structural empowerment, exemplary professional practice, new knowledge, innovation and improvements and empirical outcomes. UC San Diego Health has held its Magnet status since 2011.

Our Care Managers are essential members of our healthcare team who positively affect our patient and organization outcomes. UCSD is a tertiary level acute hospital, so the Care Managers coordinate care for medically complex patients allowing them to use their strong critical thinking skills and creative discharge planning. The Care Management Department is comprised of highly skilled Care Managers and Social Workers to provide excellent patient care for our diverse and complex patient population. This dynamic department continues to expand and grow every year adding more valuable team members.

Under general supervision, the RN Care Manager is responsible for facilitating the patient's hospitalization from pre-admission through discharge. The Care Manager coordinates with physicians, nurses, social workers and other healthcare providers to expedite medically appropriate cost-effective care. The Care Manager applies clinical expertise and medical appropriateness criteria to resource utilization and discharge planning. The Care Manager will communicate with administration and the healthcare team as needed to facilitate patient care.

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

• Must be a graduate from an accredited school of Registered Nursing.

• Registered Nurse (RN) license issued by the State of California.

• BART or BLS at time of hire with commitment to get BART within six (6) months of hire date.

• Minimum of 3 years prior inpatient RN care manager experience in an acute care hospital, or a minimum of 3 years of inpatient RN experience in the acute care hospital setting, or a minimum of 3 years combined inpatient RN care manager and inpatient RN experience in the acute care hospital setting, within the last 7 years. Department will consider ADN candidates with a minimum of 3 years acute care inpatient RN case management experience.

• Demonstrated utilization review/discharge planning experience.

• Knowledge of payer industry, resource management, reimbursement, and evidence-based clinical practice is essential.

• Proficiency in Information Systems, databases, and computer programs including MS Office: Word, Excel, Outlook, PowerPoint, etc.

• Proven fast and accurate typing and data entry skills.

• Strongly skilled in conflict management and resolution.

• Must possess strong interpersonal skills, leadership, negotiation skills, and knowledge of hospital operations.

• BSN/MSN. (Department will consider ADN candidates with a minimum of 3 years acute care inpatient RN case management experience.)

• ACM and/or CCM certificate.

• Med/Surg, progressive care, or ED clinical RN experience.

• UCSD RN experience or RN experience in another academic medical center.

• Previous supervisory/management experience.

• RN experience in post-acute care facility or home health agency.

• Facile with Epic, ECIN (Allscripts) and/or Utilization Review / InterQual.

• Knowledge of local payers and coverage, reimbursement, and evidence-based clinical nursing practice.

• Must be able to work various hours and locations based on business needs.
• Employment is subject to a criminal background check and pre-employment physical.