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RN Case Manager - Utilization Review

University of California
Los Angeles, CA Full Time
POSTED ON 2/27/2025
AVAILABLE BEFORE 5/24/2025

Description

There's nothing more exciting and rewarding than being able to make a significant, positive difference in someone's life. At UCLA Health, you'll experience this joy every day while also enjoying the positive, supportive, and collaborative environment that makes ours one of the most loved workplaces. Join us and find out for yourself.

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.

At UCLA Health, our passion for delivering the highest quality patient care has enabled us to become a world-renowned health system with four award-winning hospitals and more than 270 community clinics throughout Southern California. We're also home to the world-class medical research and clinical education capabilities of the David Geffen School of Medicine. If you're looking to experience greater challenge and fulfillment in your career, come to UCLA Health.

Salary Range : $61.79 - $79.91 Hourly

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 teams
  • Knowledge 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.

Salary : $62 - $80

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