Would you like to be part of an organization that is committed to delivering the highest quality of medical care to our patients? Do you have a passion for using your nursing abilities in a state-of-the-art clinical environment? Then please consider applying for this full-time Case Management role. We would be happy to hear from you!
Cedars Sinai Medical Care Foundation is a Medical Group that has 63 practice medical offices located throughout Los Angeles and growing. There are 636 health care providers, specializing in Qualified Audiologist, Obstetrics/Gynecology, Rheumatology, Internal Medicine, Nephrology, Hematology/Oncology, Endocrinology, General Surgery, Ophthalmology, Hospitalist and more. Medical taxonomies which are covered include Hospice and Palliative Medicine, Otolaryngology/Facial Plastic Surgery, Registered Nurse, Gynecology, Vascular & Interventional Radiology, Surgery, Clinical, Nuclear Radiology, Psychiatry, Neurology and many more.
As an Ambulatory Care Case Manager, you will be responsible for the coordination of care for patients throughout the continuum of treatment; from initial referral to follow-up care, serving as a consistent contact, or point person for the high-risk patient. You can look forward to collaborating and operating as a member of the interdisciplinary team, as well as acting as a patient advocate throughout the patient care process.
Summary of Essential Duties:
Make an outreach call within 24 hours of urgent referrals, 72 hours for routine referrals and initiates and or completes Ambulatory Care Management assessment and care-plan.
Complete assessment for current/past medical conditions with dates of diagnosis, psychosocial issues, medications, ADL’s, and pain.
Assess for cultural/linguistic needs, mental status, depression screening, available benefits, member/caregiver goals, degree of involvement, and resources; barriers to treatment.
Ensure managed care referrals are processed, per NCQA Guidelines, and appropriately documented in Access Express.
Process all appropriate services based upon covered benefits, health plan or Milliman Care Guidelines, or medical necessity.
Monitoring of continued appropriateness of the services rendered i.e. home health, DME, outpatient therapy.
Transitions of Care Hand-Off, to assigned ISP CM, when ACM patients are admitted to Cedars-Sinai Medical Center.
Ambulatory case managers will contact the patients telephonically, within 48 hours, post-discharge.
Refer high risk patients to Supportive Care Services Program, and NP House Call Programs, as appropriate.
Coordinate referrals and secure appointment with various Disease Management programs such as Anticoagulation Clinic, Asthma, Diabetes, Hepatitis C, Smoking Cessation, Cardiovascular Risk, as appropriate.
Qualifications:
Education:
Graduate of an accredited nursing program required (LVN or RN)
License/Certifications:
Current, unrestricted California LVN or RN license required
BLS from the American Heart Association or American Red Cross
Certified Case Manager (CCM) preferred
Experience:
A minimum of 2 years of nursing experience required
At least 1 year of Case Management experience required
Bilingual in Spanish, Korean, Farsi or other foreign language is beneficial
Internal Description
Would you like to be part of an organization that is committed to delivering the highest quality of medical care to our patients? Do you have a passion for using your nursing abilities in a state-of-the-art clinical environment? Then please consider applying for this full-time Case Management role. We would be happy to hear from you!
Cedars Sinai Medical Care Foundation is a Medical Group that has 63 practice medical offices located throughout Los Angeles and growing. There are 636 health care providers, specializing in Qualified Audiologist, Obstetrics/Gynecology, Rheumatology, Internal Medicine, Nephrology, Hematology/Oncology, Endocrinology, General Surgery, Ophthalmology, Hospitalist and more. Medical taxonomies which are covered include Hospice and Palliative Medicine, Otolaryngology/Facial Plastic Surgery, Registered Nurse, Gynecology, Vascular & Interventional Radiology, Surgery, Clinical, Nuclear Radiology, Psychiatry, Neurology and many more.
As an Ambulatory Care Case Manager, you will be responsible for the coordination of care for patients throughout the continuum of treatment; from initial referral to follow-up care, serving as a consistent contact, or point person for the high-risk patient. You can look forward to collaborating and operating as a member of the interdisciplinary team, as well as acting as a patient advocate throughout the patient care process.
Summary of Essential Duties:
Make an outreach call within 24 hours of urgent referrals, 72 hours for routine referrals and initiates and or completes Ambulatory Care Management assessment and care-plan.
Complete assessment for current/past medical conditions with dates of diagnosis, psychosocial issues, medications, ADL’s, and pain.
Assess for cultural/linguistic needs, mental status, depression screening, available benefits, member/caregiver goals, degree of involvement, and resources; barriers to treatment.
Ensure managed care referrals are processed, per NCQA Guidelines, and appropriately documented in Access Express.
Process all appropriate services based upon covered benefits, health plan or Milliman Care Guidelines, or medical necessity.
Monitoring of continued appropriateness of the services rendered i.e. home health, DME, outpatient therapy.
Transitions of Care Hand-Off, to assigned ISP CM, when ACM patients are admitted to Cedars-Sinai Medical Center.
Ambulatory case managers will contact the patients telephonically, within 48 hours, post-discharge.
Refer high risk patients to Supportive Care Services Program, and NP House Call Programs, as appropriate.
Coordinate referrals and secure appointment with various Disease Management programs such as Anticoagulation Clinic, Asthma, Diabetes, Hepatitis C, Smoking Cessation, Cardiovascular Risk, as appropriate.
Qualifications:
Education:
Graduate of an accredited nursing program required (LVN or RN)
License/Certifications:
Current, unrestricted California LVN or RN license required
BLS from the American Heart Association or American Red Cross
Certified Case Manager (CCM) preferred
Experience:
A minimum of 2 years of nursing experience required
At least 1 year of Case Management experience required
Bilingual in Spanish, Korean, Farsi or other foreign language is beneficial
Working Title: Case Manager, RN or LVN Department: MNS ISP Business Entity: Medical Network Job Category: Patient Services Job Specialty: Case Management Position Type: Full-time Shift Length: 8 hour shift Shift Type: Day
Providing healthcare for more than 100 years, Cedars-Sinai has evolved into one of the most dynamic and highly renowned medical centers in the world. Along with caring for patients, Cedars-Sinai is a hub for biomedical research and a training center for future physicians and other healthcare professionals. This attracts exceptional talent to Cedars-Sinai, including world-renowned physician-scientists who seek a place where they can both conduct research and see patients--the ideal formula for discovery and its translation into cures. Our patients benefit from access to doctors at the top of their fields, and our researchers have an ideal community in which to study the impact of healthcare challenges, and reflect that knowledge in their research. The greater Los Angeles area in which Cedars-Sinai resides possesses unparalleled cultural and ethnic diversity which offers outstanding opport...unities for translational and clinical research and a dynamic environment for medical education.Although community based, Cedars-Sinai is a major teaching hospital affiliated with the David Geffen School of Medicine at the University of California, Los Angeles (UCLA). Cedars-Sinai has highly competitive graduate medical education programs in more than 50 specialty and subspecialty areas, a graduate program in biomedical sciences and translational medicine, a clinical scholars program directed towards junior physicians with aspirations to become clinical scientists, and post graduate training opportunities.There are more than 250 full-time faculty members at Cedars-Sinai. The voluntary medical staff, comprised of more than 2,200 specialty board-certified or board-qualified physicians, represent all of the specialties and subspecialties and collaborate with full-time medical staff in the teaching responsibilities of the graduate medical education programs.
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