Under the direction of the RN Asst. Director for Utilization Review, Intensive Case Management, you will support and perform duties to provide discharge planning/UM concurrent review of the complex cases admitted in Non Domestic Hospital. The Nurse Case Manager uses the nursing process to identify and advocate for patient issues. You will work collaboratively with the patient, Faculty Practice Group, community resources, other providers, managed care operations, the UCLA Health System, and health plans to implement, identify, coordinate, and monitor options and services to meet at-risk patients' healthcare needs.

The Nurse Case Manager/Clinical Advisor aims to foster continuity of care and reduce unnecessary utilization of healthcare services by coordinating and providing health services to meet individuals’ health needs. This is achieved by connecting key individuals involved in the care of the patient and decreasing fragmentation and duplication of care, the Nurse Case Manager/Clinical Advisor is able to enhance the quality and cost effectiveness of the care that is delivered across all settings and levels of care.

Salary range: $143,675 - $185,811/Annual

Minimum of 2 years’ experience in utilization management, Health Plan or Medical Group CM or equivalent clinical Experience.

• Must have strong problem solving skills. Ability to analyze problems and formulate plans, solutions and a course of action given changing circumstances.
• Excellent organizational and time management skills, including the ability to handle multiple conflicting priorities simultaneously. Strong ability to prioritize.
• Demonstrate proficiency in computer skills such as Windows computer function, computer navigation, and ability to use computerized patient care systems.
• Competence in navigating the internet/intranet and use of browser software such as Microsoft Explorer and applications such as Excel, Word, and PowerPoint
• Excellent interpersonal, verbal and written communication skills. Ability to articulate clinical and non-clinical information to individuals of all levels of understanding.
• Ability to be flexible and work according to availability of office personnel, patient and resources required to coordinate care of patient.