(RN) Case Manager - Population Health - Hybrid - 136941

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.

The RN Case Manager (CM) will work in Population Health's Care Connections Hub completing a high volume of post discharge telephonic outreaches, to ensure all patients have what they need once returning home after an inpatient hospitalization or Skilled Nursing stay. The RN CM will assist with the care coordination of each patient, to ensure an understanding of their discharge diagnosis, post DC instructions, medication review, timely home health or durable medical equipment (DME) needs, next steps in their plan of care and identify barriers to care. The RN CM must be self-driven to achieve daily case loads, have strong communication skills, the ability to conduct difficult phone conversations, and close the loop or escalate any barriers that may put a patient at greater risk of an avoidable readmission..

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

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

• Prior case management experience in large, acute care or community setting and /or Utilization review in hospital or IPA setting. MCG and/or InterQual experience.

• Strong teamwork and interpersonal skills.

• Must have proven autonomous problem solving, independent thinking, decision making, and prioritizing skills.

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

• BSN/MSN

• ACM and/or CCM

• Prior experience with referral processing, utilization review, discharge planning and benefits description with customers.

• Autonomy and productivity proven in the home environment statement.

• Proficiency in Electronic Health Records (EHR) (Epic preferred).

• Previous experience working in Population Health.

• Three to five (3-5) years of clinical RN experience or in an acute care or post acute care / community setting.

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

• This position is a hybrid of up to one day on site and four days at home. On-site work required during the training period Monday-Saturday 8:30am-4:30pm, then hybrid work from home and office when skills are proficient. One Saturday per month with a flex day off during the same week.

• 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.