Location: Los Angeles, California
Internal Number: HRC1193654A
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.
- Graduate of an accredited RN program required
- Current, unrestricted California RN license required
- BLS from the American Heart Association or American Red Cross
- Certified Case Manager (CCM) preferred
- 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
Case Manager - RN PRDMDepartment:
MNS ISPBusiness Entity:
Cedars-Sinai Medical CenterJob Category:
Patient ServicesJob Specialty:
Case ManagementPosition Type:
Per DiemShift Length:
8 hour shiftShift Type:
$48.26 - $72.39