Nurse Navigator - DHI Admin SL - FT Days

About the Organization

UCI Health is one of California's largest academic health systems and the clinical enterprise of the University of California, Irvine. Established on July 1, 1976, UCI Health has grown into a 1,461-bed health system that includes UCI Health - Orange, UCI Health - Irvine, four Community Network hospitals, and a growing network of ambulatory care centers across Orange and Los Angeles counties.

As Orange County’s only academic health system, UCI Health is home to the only National Cancer Institute-designated comprehensive cancer center based in the county, the region’s only American College of Surgeons-verified Level I adult and Level II pediatric trauma center, American College of Emergency Physicians Gold Level 1 Geriatric Emergency Department, and a nationally recognized regional burn center verified by the American Burn Association. Powered by UC Irvine, UCI Health serves 5.6 million people across Orange County, western Riverside County, and southeast Los Angeles County through excellence in patient care, research, and medical education.

About the Role

Under the direction of the Administrative Manager, the case manager collaborates with the attending and resident medical staff, as well as nursing, ancillary, and technical staff to coordinate the delivery of high-quality, individualized, cost-effective patient care. Coordinates resource utilization throughout the HealthSystem and evaluates services provided. Coordinates interdisciplinary referrals utilizing pre-established criteria for quality and appropriateness to the acute care or ambulatory setting.

Performs the appropriate utilization review functions on the managed population utilizing approved Intensity of Service and Severity of Illness criteria. Supports the performance improvement process through comprehensive analysis of patterns and trends. Interacts with the patient/family. Utilizes the nursing process, as appropriate, to set priorities, plan, organize, and implement care that is directed toward self-care outcomes.

Responsibilities

• Collaborate with medical, nursing, ancillary, and technical staff to coordinate high-quality, cost-effective patient care.
• Coordinate resource utilization and evaluate services provided throughout the HealthSystem.
• Coordinate interdisciplinary referrals using pre-established criteria for acute care or ambulatory settings.
• Perform utilization review functions using approved Intensity of Service and Severity of Illness criteria.
• Support performance improvement through analysis of patterns and trends.
• Interact with patients and families.
• Utilize the nursing process to plan, organize, and implement care directed toward self-care outcomes.

Requirements

• Must possess the skill, knowledge, and ability essential to the successful performance of assigned duties.
• Must demonstrate customer service skills appropriate to the job.
• Minimum 2 years of clinical experience.
• Excellent written and verbal communication skills in English.
• Current CA RN license.
• Basic Life Support Certification from AHA.
• Bachelor of Science in Nursing (required for external candidates).
• Ability to maintain a work pace appropriate to the workload.

Preferred Qualifications

• Bilingual in English/Spanish or English/Vietnamese (certain clinics may require this qualification).

Benefits

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.
• Access to a number of discounts and perks.