Senior Case Management Coordinator - Ambulatory Case Management
Cedars-Sinai Medical Center
Location: Beverly Hills, California
Internal Number: HRC1226969
The Senior Case Management Coordinator provides support to the ambulatory case management processes and Ambulatory Nurse Case Managers. The coordinator reviews ACM referrals and patient information daily and enters and updates referrals into the Access Express system as per departmental policy. In addition, the Coordinator assists in identifying, tracking, and coordinating services for patients who fall under/qualify for the department's ambulatory and disease state management programs. These patient populations include medically and socially fragile patients, patients who inappropriately access services, and patients who have complicated medication regimens and need an additional supportive assistance.
Duties & Responsibilities:
Reviews pertinent patient information and enters/updates inpatient, SNF, home health and DME referrals as needed.
Ensures that appropriate documentation is uploaded as part of the electronic medical record (EMR).
Responds to Health Plan inquiries regarding case management services and directs inquiries to appropriate care managers, as appropriate.
Coordinates follow-up care and appointments with pts care team (PCP, Specialist, pharmacist, etc.)
Prioritizes and processes, as per policy, referrals for target patient populations (i.e.: fragile seniors, catastrophic and transplant cases, frequent utilizer of ER and inpatient services), as well as patients diagnosed with specific diseases (i.e.: cancer, asthma, COPD, AIDS, etc.).
Acts as a liaison, captures information and tracks all patients referred to the ACM program.
Assists in coordinating care for specific high risk/high cost patient population, including referrals to community resources, facilitation of medical services, referral to ancillary providers, etc.
Documents all patient specific information in appropriate information systems.
Assists in verifying health plan benefits and coordinating ambulatory services.
Assists in training new members of the department in referral entry and eligibility verification, as well as other department policies and procedures.
High school diploma/GED required.
Three (3) years of healthcare experience, a general knowledge of medical terminology and experience with community resources and social supports required.
Three (3) years of previous utilization management, medical assistant or managed care experience highly preferred. Experience with community resources and social supports; previous case management, utilization management, or discharge planning experience. Knowledgeable with HMO, Medicare, and MediCal/Medicaid guidelines.
Working Title: Senior Case Management Coordinator - Ambulatory Case Management Department: Ambulatory Care Management Business Entity: Cedars-Sinai Medical Center Job Category: Patient Services Job Specialty: Case Management Position Type: Full-time Shift Length: 8 hour shift Shift Type: Day Base Pay:$22.12 - $33.18
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 oppor...tunities 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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