Nurse Manager, Case Management & Utilization Management

Work Location

Orange, California

Work Shift

Day – 08hrs (United States of America)

Why CHOC?

At CHOC, we strive to be the leading destination of children’s health by providing exceptional and innovative care. We are responsible for the overall health of our community’s pediatric population in our hospitals, clinics, and practices. And because of our breadth of care, your career at CHOC can be as diverse and fulfilling as you determine. CHOC’s compensation structure, benefits offerings, and career development programs are geared to helping you achieve your professional and personal goals. Apply now to see where your career at CHOC can take you.

Environmental Sustainability Statement

Driven by the connection between children's health and a healthy environment, we commit to creating a healthcare model that incorporates environmental sustainability aligned with our mission to protect children's health and patient safety.

Job Summary

The Manager of Care Management & Social Services is accountable for managing the personnel and financial resources including the day-to-day operations, staff performance, education, and budgetary monitoring. Ensures that quality care is provided according to policies and procedures, that patient flow/placement is efficient, and that daily staffing needs are met to assure the highest quality care, safety and satisfaction. Provides leadership for the clinical and administrative functions of the department.The position we are looking to fill will be managing our Inpatient RN Care Managers, as well as our Utilization Review team. The ideal candidate will have experience in both case management and utilization review, and have solid working knowledge of McG criteria and utilization review guidelines, CalOptima and CCS regulations, and the ability to work cohesively with a leadership team that oversees this multidisciplinary department.This position does require a California RN License in good standing to oversee the work of the team.

Pay Range

Minimum $133,827 Midpoint $177,320 Maximum $220,792

Rate of pay is determined by various factors, including but not limited to knowledge, skills, competencies, experience, education, as well as position requirements.

Experience

Required: Minimum five (5) years of clinical experience with at least three (3) years in case management or social services. One (1) year of experience managing the function in the healthcare industry.

Preferred: Seven (7) years of previous clinical and management experience in an acute medical facility. Previous clinical experience in pediatrics.

Education

Required: Bachelor's Degree in Nursing (BSN)

Preferred: Master's Degree in Nursing (MSN).

Training

Required: None required.

Specialized Skills

Required: Ability to set goals and judge results in accordance with the highest standard; care with sensitivity and respect; advance care through development of new ideas and technology; promote teamwork to achieve CHOC's mission; and understand and exceed customer expectations. Written and verbal communication skills. Interpersonal skills. Strong analytical and organization skills; excellent critical thinking, judgment, and problem-solving skills to understand and anticipate the impact and opportunities across multiple critical projects. Proficient literacy in Windows applications, especially Excel and Word. Demonstrated strength in building and articulating a vision and setting goals. Ability to build and establish positive relationships with stakeholders and staff at all levels. Experience managing multiple projects while maintaining exceptional customer service standards. Experience presenting findings / recommendations to Executive level audiences. Intermediate or advanced computer, spreadsheet, & database skills. Strong verbal and written communication skills; interpersonal relationship and collaboration skills.

Preferred: Intermediate or advanced computer, spreadsheet, & database skills.

Licensure

Required: Licensed Registered Nurse- CA (RN) or Licensed Clinical Social Worker- CA (LCSW); RQI Responder – American Heart Association. Pediatric Advanced Life Support (PALS).

Work Environments- Functional Demand:

Light - Moderate energy level Lift and carry 25-35 lbs. Push/pull 50-100 lbs. (ie. empty bed, stretcher).

Physical Activity Requirements:

Bending, Carry Objects, Climbing, Keyboard use/repetitive motion, Pinching/fine motor activities, Push/Pull, Reaching forward, Reaching overhead, Sitting, Squat/kneel/crawl (Squad & Knee), Standing, Talk or hear, Taste or smell, Twisting, Walking, Wrist position deviation

Physical Activity Lifting

Lifting (Floor to waist level) - Constant 67 or more%, Lifting (Floor to waist level)- Frequent 36-66%, Lifting (Floor to waist level) - Occasional 0-35%, Lifting (Waist level and above) - Constant 67 or more%, Lifting (Waist level and above)- Frequent 36-66%, Lifting (Waist level and above) - Occasional 0-35%

Sensory Requirements:

Color Discrimination, Depth Perception, Far Vision, Hearing, Near Vision

Environment Requirements:

Airborn Communicable Disease, Bloodborne Pathogens, Chemical, Dust Particular Matter, Extreme Noise Levels, Extreme Temperatures, Radiation, Uneven Surfaces or Elevations

Non-Discrimination Statement:

CHOC does not discriminate on the basis of age, race, color, religion, national origin, ancestry, marital status, genetic information, disability, sex, gender (including pregnancy, breastfeeding, childbirth, lactation or related medical conditions), gender identity or expression, medical condition, sexual orientation, veteran status, military or uniformed service member status, or other protected characteristics in accordance with state and federal laws.

We encourage individuals from all backgrounds to apply for positions at CHOC, even if your experience doesn’t align perfectly with the listed qualifications for a particular role, as your unique experience may be a great addition to our culture for another one of our opportunities.

If you desire support or accommodations throughout the Talent Acquisition process, please inform your Talent Acquisition Partner.