(RN) High-Risk Case Manager - Population Health - 137853

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.

Under the general supervision of the UCSD at Home Program Manager, the RN Case Manager is responsible for our high risk patients and our adverse selected members in compliance with Health Plan and CMS regulations and delegation. Will work closely with our Medical Director and High Risk Program Manager. To be highly visible and engage in the Clinics, Clinic Managers, and Physician Leadership. The Case Manager applies clinical expertise and medical appropriateness criteria to resource utilization, discharge planning and follow up. Will attend regular onsite conferences with Case Managers, Clinic Staff, and other community partners as needed.

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

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

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

• Understanding of Population Health and Value-Based Care models.

• Prior case management, utilization review, and discharge planning experience. Willing to consider candidates without case management experience who have three (3+) or more years of recent acute care clinical RN experience.

• Strong interpersonal skills.

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

• BSN/MSN

• CCM

• Lean Six Sigma yellow belt or above.

• Three (3+) or more years of clinical RN experience.

• Proven home care, managed care, or similar case management experience.

• Proven home care, managed care, or similar case management experience.

• 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.
• This position will be a hybrid of work from home and on-site, with more being work from home once new hire is capable with their CCM knowledge.

If employed by the University of California, you will be required to comply with our Policy on Vaccination Programs, which may be amended or revised from time to time. Federal, state, or local public health directives may impose additional requirements.

If applicable, life-support certifications (BLS, NRP, ACLS, etc.) must include hands-on practice and in-person skills assessment; online-only certification is not acceptable.

UC San Diego Health is the only academic health system in the San Diego region, providing leading-edge care in patient care, biomedical research, education, and community service. Our facilities include two university hospitals, a National Cancer Institute-designated Comprehensive Cancer Center, Shiley Eye Institute, Sulpizio Cardiovascular Center, the only Burn Center in the county, and and dozens of outpatient clinics. We invite you to join our team!

Applications/Resumes are accepted for current job openings only. For full consideration on any job, applications must be received prior to the initial closing date. If a job has an extended deadline, applications/resumes will be considered during the extension period; however, a job may be filled before the extended date is reached.

To foster the best possible working and learning environment, UC San Diego strives to cultivate a rich and diverse environment, inclusive and supportive of all students, faculty, staff and visitors. For more information, please visit UC San Diego Principles of Community.

The University of California is an Equal Opportunity 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 status under state or federal law.

For the University of California's Anti-Discrimination Policy, please visit: https://policy.ucop.edu/doc/1001004/Anti-Discrimination

UC San Diego is a smoke and tobacco free environment. Please visit smokefree.ucsd.edu for more information.

UC San Diego Health maintains a marijuana and drug free environment. Employees may be subject to drug screening.

Misconduct Disclosure Requirement: As a condition of employment, the final candidate who accepts an offer of employment will be required to disclose if they have been subject to any final administrative or judicial decisions within the last seven years determining that they committed any misconduct; or have filed an appeal of a finding of substantiated misconduct with a previous employer.

a. "Misconduct" means any violation of the policies governing employee conduct at the applicant's previous place of employment, including, but not limited to, violations of policies prohibiting sexual harassment, sexual assault, or other forms of harassment, or discrimination, as defined by the employer. For reference, below are UC's policies addressing some forms of misconduct:

• UC Sexual Violence and Sexual Harassment Policy
• UC Anti-Discrimination Policy
• Abusive Conduct in the Workplace