What are the responsibilities and job description for the Cord, Quality/PI, Utilization Review Coordinator - Full Time Days - LAK position at University of California, Irvine?
UCI Health is the clinical enterprise of the University of California, Irvine, and the only academic health system based in Orange County. UCI Health is comprised of its main campus, UCI Medical Center, a 459-bed, acute care hospital in in Orange, Calif., four hospitals and affiliated physicians of the UCI Health Community Network in Orange and Los Angeles counties and ambulatory care centers across the region. Listed among America’s Best Hospitals by U.S. News & World Report for 23 consecutive years, UCI Medical Center provides tertiary and quaternary care and is home to Orange County’s only National Cancer Institute-designated comprehensive cancer center, high-risk perinatal/neonatal program and American College of Surgeons-verified Level I adult and Level II pediatric trauma center, gold level 1 geriatric emergency department and regional burn center. UCI Health serves a region of nearly 4 million people in Orange County, western Riverside County and southeast Los Angeles County.
To learn more about UCI Health, visit www.ucihealth.org.
Your Role on the Team
Position Summary:
The Case Management Operations Coordinator / APC Coordinator provides system support services for the Case Management Staff. The Coordinator assists the Director of Case Management for hospital utilization performance improvement and daily operations of the case management department to promote effective utilization of hospital resources, ensure processes support appropriate reimbursement for services rendered, support efficient patient throughput and ensure compliance with all state and federal regulations related to case management services. This position also manages the CDM and assists hospital departments relating to billing. This position integrates national standards for case management scope of services including: Utilization Management supporting medical necessity and denial prevention; Ensuring transition management promoting appropriate length of stay, readmission prevention and patient satisfaction; Compliance with state and federal regulatory requirements, TJC accreditation standards and Tenet policy; Education provided to facility staff.
What It Takes to be Successful
Total Compensation
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. Please utilize the links listed here to learn more about our compensation practices and benefits.
Required Qualifications:
- Must possess the skill, knowledge and ability essential to the successful performance of assigned duties
- Must demonstrate customer service skills appropriate to the job
- Excellent written and verbal communication skills in English
- Ability to maintain a work pace appropriate to the workload
- Ability to establish and maintain effective working relationships across the Health System
- Mandatory: Required skills include demonstrated organizational skills, excellent verbal and written communication skills, ability to lead and coordinate activities of a diverse group of people in a fast paced environment, critical thinking, problem solving skills and computer literacy. Ability to review medical charts and verify services rendered. Ability to review physician’s orders and determine appropriate level of care based on services rendered. Physical Requirements: While performing the duties of the job, the employee is regularly required to sit, talk and hear. The employee is frequently required to use fine motor skill (typing/data entry), and reach with hands and arms. The employee is frequently required to stand, walk, occasionally stoop, kneel or crawl. The employee must regularly lift and/or move up to 20 pounds.
Preferred Qualifications:
- 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 Scan
- Legal Right to Work in the United States
- Vaccination Policies
- Smoking and Tobacco Policy
- Drug Free Environment
The following additional conditions may apply, some of which are dependent upon business unit or job specific requirements.
- California Child Abuse and Neglect Reporting Act
- E-Verify
- Pre-Placement Health Evaluation
Details of each policy may be reviewed by visiting the following page: https://hr.uci.edu/new-hire/conditions-of-employment.php
Closing Statement:
The University of California, Irvine is an Equal Opportunity/Affirmative Action 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 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.
Consideration for Work Authorization Sponsorship
Must be able to provide proof of work authorization
