TheManager, reports to the Director of Care Coordination and is responsible forproviding leadership and management of clinical case management, clinicalsocial work, utilization management, and discharge planning. The Manager assumes complete oversight of thedaily operation of her/his assigned service line and represents the departmentand UCLA Health System to internal and external customers including patientsand families, nursing, physicians and ancillary medical personnel, service lineleadership, administration, other hospitals, health plans and other third-partypayors. The Manager assists the Directorwith systems, processes, and outcomes of clinical care teams and programsdesigned to address clinical, psychosocial, and financial needs of patients andfamilies. Scope of responsibilityincludes personnel management of a multidisciplinary team, regulatorycompliance, collaboration across the organization, safety and risk management,performance improvement, staff education, and policy implementation. The Manager possesses outstandingcommunication skills, broad clinical expertise, superior organization to managemultiple tasks concurrently, and exemplary leadership and collaborative skills.
2 years clinical experience and a minimum of 5 years managerial experience or equivalent combination.
CurrentCalifornia R.N./LCSW – required
BSN or MSW – required
Skills, Knowledge and Abilities
Working knowledge of the principles of management.
Demonstrated knowledge and understanding of managed care and commercial insurance, Medi-Cal, Medicare, and CCS.
Demonstrated leadership and organizational abilities with previous demonstration of consistency, independence, flexibility, initiative, and creativity.
Working knowledge of utilization management principles and processes.
Demonstrated resourcefulness, effective written and verbal communications, diplomacy, organizational, and analytic skills.
Self-directed, assertive, and creative in problem solving, systems planning, and patient care management.
Ability to work independently, handles a high degree of responsibility, and prioritizes multiple assignments.
Skill in analyzing information, data, and problems.
Working knowledge of laws, rules and regulations regarding utilization review of government programs such as Medicare, Medi-Cal, and CCS.
General knowledge of rules and regulations governing third party reimbursement or the medical review agency.
Ability to design and/or implement data collection tools.
Understanding of health care, healthcare delivery systems and managed care.
Strong analytical skills..
UCLA is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected Veteran status.