Description The Managed Care Utilization Management includes the responsibilities of Utilization Management for the HMO capitated membership assigned to the UC Davis Medical Group.
Position Information Salary Range : $55.76 to $81.69 Salary Frequency : Hourly No. of Positions : 1 Appointment Type : Career Percentage of Time : 100% Shift Hour : Monday to Friday 8am-5pm Location : Broadway Building City : Sacramento Union Representation : Yes Benefits Eligible : Yes
We offer exceptional employment benefits including medical, dental, and vision plans, generous paid vacations and holidays, excellent retirement savings and investment plans, continuing education, and reduced fee and scholarship programs.
This is not an H-1B opportunity.
Qualifications -Graduation from an accredited School of Nursing, -Possession of current California RN License. -BSN preferred for internal candidates, external candidates and per diem conversions. -UR and DCP experience preferred. -Minimum of 3 years recent experience in an acute care setting. -Knowledge and experience with HMO Health Plan or Medical Group/IPA Utilization Management/Case Management or acute care facility discharge planning functions recommended.. -Broad-based clinical experience in multiple clinical settings preferred. -Skills to perform in-depth chart analysis. -Experience in identifying and analyzing care/service needs for case managed patients. -Knowledge of care/services provided in differing levels of care, i.e., ambulatory and institutional settings. -Knowledge of medical and nursing treatment plans. -Clinical skills and knowledge to assess type and amount of home health care necessary to meet patients' needs in the home setting.
SPECIAL REQUIREMENT -Occasional overtime and/or flexible hours may be necessary as determined by the Department. -THIS POSITION MAY BE SUBJECT TO A CRIMINAL BACKGROUND INVESTIGATION, DRUG SCREEN, LIVE SCAN FINGERPRINTING, MEDICAL EVALUATION CLEARANCE, AND FUNCTIONAL CAPACITY ASSESSMENT
Responsibilities The Case Manager performs utilization review for inpatient UC Davis capitated patient, patients admitted to external hospitals and review appropriateness of outpatient services (prior 'authorizations). This position will receive direction concerning the overall goals and objectives of the department and will participate in action to achieve those goals.
The University of California is an Equal Opportunity/Affirmative Action Employer advancing inclusive excellence. 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.
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UC Davis is the home of the Aggies — go-getters, change makers and problem solvers who make their mark at one of the top public universities in the United States. Since we first opened in 1908, we’ve been known for standout academics, sustainability and Aggie Pride as well as valuing the Northern California lifestyle. These themes are woven into our 100-plus-year history and our reputation for solving problems related to food, health, the environment and society.Our 5,300-acre campus is in the city of Davis, a vibrant college town of about 68,000 located in Yolo County. The state capital is 20 minutes away, and world-class destinations such as the San Francisco Bay Area, Lake Tahoe and the Napa Valley are within a two-hour drive.