Ambulatory Care Manager, CHOC Health Alliance

CHOC•Irvine, CA

4d•$53 - $87•Onsite

About The Position

The Ambulatory Care Manager utilizes the nursing process to help members/ families that have experienced a critical event or have a diagnosis requiring extensive resources. Ensure care is delivered in an efficient and cost-effective manner in an effort to achieve optimal clinical outcomes.

Requirements

Minimum two (2) years of pediatric nursing experience and /or case management experience.
Graduation from an accredited school of Registered Nursing
Bachelor of Science degree in Nursing (BSN) Education
Ability to work effectively under pressure due to changing priorities.
Excellent interpersonal communication, including conflict resolution, problem solving, and negotiation skills.
Clinical knowledge of multiple age groups, medical illness, and treatment plans according to disease process, diagnosis, and anticipated LOS.
Strong organizational and time management skills, as evidenced by capacity to multi-task and prioritize.
Ability to work independently and exercise sound judgment in interactions with physicians, payers, patients, and their families.
Demonstrates the knowledge and skills necessary to communicate with third party payers to obtain authorization for the appropriate treatment setting for patients requiring medical, psych, and chemical dependency treatment.
Must be proficient in required competencies upon completion of orientation and maintain annual departmental competency requirements.
Ability to work collaboratively regardless of social, economic, and cultural backgrounds.
Computer knowledge to include skills in using Microsoft Office (Excel, Word, Power Point, Access).
Registered Nurse – CA (RN).

Nice To Haves

Three (3) years of pediatric nursing experience and/or case management, care coordination, or transition of care.
Master of Science in Nursing or master’s degree in a health-related field from an accredited school.
Certification in Utilization Review and/or Case Management Certified Pediatric Nurse.
Knowledge of CCS/Medi-Cal regulations and requirements
Knowledge of clinical review and authorization requirements for Medi- cal.
Ability to apply severity of illness/intensity of service pediatric criteria to information extracted from clinical documentation.
Bilingual in English/ Spanish.
Ped Emerg Assess Recog & Stabil (PEARS)
Pediatric Advance Life Support (PALS).
Basic Life Support (BLS)