RN Utilization Review - Lakewood - PT Days Exempt

Who We Are

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 individual in this position is responsible for coordinating patient care activities to conform to evidence-based practice and / or regulatory / payor requirements. This position integrates functions typically considered to be case management, care coordination and / or utilization management, and discharge planning assessment. As such, the individual's responsibilities will include, but not limited to the following activities : a) coordinating care; b) planning for discharge needs and arrangements, including leading multidisciplinary discharge planning teams and assessing patients for discharge planning needs; c) reviewing utilization patterns; d) referring complex social issues to social work; e) managing concurrent denials; f) coordinating weekly Complex Case Review; g) collecting clinical process and outcomes data, including Ecare; h) communicating with patients and their families around plan of care; I) assisting with physician documentation; j) arranging for patient education; k) communicating and collaborating with physicians, their office staff and staff of ancillary departments (e.g., lab, pharmacy); l) assist with ensuring accuracy of patient demographic and insurance information; and m) assisting with making the appropriate referrals to other departments (e.g., PT / OT / ST).

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 :

• Current CA RN license
• Conversant knowledge and experience with case management, care coordination, and / or utilization review
• Demonstrate the ability in collaborating with physicians
• Ability to lead and coordinate activities of a diverse group of people
• 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

Preferred Qualifications :

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 :

The following additional conditions may apply, some of which are dependent upon business unit or job specific requirements.

Details of each policy may be reviewed by visiting the following page :

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 or at , 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