Facilitate and process new patient referrals, utilizing advanced nursing skills in the assessment and planning of clinical care for the international patient and other identified group of patients. Review patients' medical conditions with their home country physicians to coordinate, clarify needs and expectations as well as to coordinate transfer of care back to home country physicians after receiving care at UCLA. Coordinate with physicians, staff, and non-UCLA providers and facilities regarding patient care. Collaborate with Attending, Resident and Intern medical staff, as well as with Resource Planning, Nursing, ancillary, professional, technical and financial staff to coordinate delivery of high quality care, develop plans of care and discharge plans, monitor all clinical activities, make recommendations for alternative levels of care, as appropriate, identify cost-effective protocols, and develop guidelines for care. Provide medical updates to embassy sponsors and other payors on a regular and as needed basis; perform appropriate utilization review functions. Concurrently intervene, when appropriate, to enhance patient quality outcomes.
Minimum of three years acute hospital experience, or the equivalent of education and experience.
Recent experience in case management, utilization management or discharge planning
Experience in leading a team or managing people
Self-directed, assertive and creative in problem solving, systems planning and patient care management in a high volume work environment
Demonstrate resourcefulness, effective written and oral communication, diplomacy, organizational and analytical skills required.
Demonstrated ability to respond quickly and diplomatically to conflict by acting to understand the issues, and suggest fair and equitable solutions. Ability to analyze a situation, identify alternative solutions and develop specific actions.
Demonstrated experience, ability and skill working in a high volume, fast-paced environment and requires the need to use good judgment due to conflicting or multiple goals and priorities.
Consistently demonstrate and encourage a commitment to quality, customer-centeredness, productivity and continuous improvement.
Ability to work effectively and collaboratively with interdisciplinary teams.
Excellent computer skills
Basic working knowledge of a large University teaching hospital, its purpose and functions.
Ability to communicate effectively with physicians, staff, payors and patients the medical necessity/appropriateness/level of care criteria that is necessary for acute care hospitalization.
Skill in abstracting and interpreting medical information from patient records.
Skill in setting priorities that accurately reflect the relative importance of job responsibilities.
Working knowledge of laws, rules and regulations regarding utilization review and discharge planning functions.
Clinical experience sufficient to understand and communicate medical diagnosis and courses of treatment to professional and non-professional personnel.
Ability to develop and individualized case management plan that addresses physical, vocational, psychosocial, financial and educational needs.
Fluent in second language highly preferred.
Proven working experience in case management, including as a nurse, medical, mental health care manager or a related job
Excellent knowledge of case management principles, healthcare management and reimbursement
Previous experience with psychological aspects of care
Effective communication skills
Excellent organizational and time management skills
Familiarity with professional and technical emerging knowledge
Problem solving skills and ability to multi-task
Compassionate with teamwork skills
Current CA RN License
Employment/Position Type:Full Time
Share On :