![Cedars-Sinai](https://media.trabajo.org/img/noimg.jpg)
Case Management Coordinator
3 weeks ago
Job Description
The Case Management Coordinator provides support to the utilization review process. The coordinator works collaboratively with all team members of Utilization Management, Patient and Provider Services, Claims Department and other Care Coordination Department staff. In addition, the coordinator assists in identifying, tracking and coordinating services for patients when needed. The position requires strong written and communication skills and the ability to interact with Medical Directors, Providers, CSMNS members, Medical Group and IPA's to ensure the delivery of high quality, cost-effective healthcare and aligned with all state and federal regulations and guidelines.
Duties and Responsibilities:
Enters data and processes referral authorization requests, to include appropriate coding and quantities.
Answers incoming calls from Providers, IPAs, Medical Groups and other internal and external calls and assists on the queues as needed.
Is responsible for the Fax Inbox and appropriately distributes incoming faxes. Ensures that internal compliance security measures are met.
Verifies member eligibility before processing authorizations.
Contacts facilities identified by the UM Nurses/Manager/Director/Medical Director to research any issues (i.e. contract, discharges, services provided).
Identifies non-contracted providers and requests Letter-of-Agreements when requested.
Requests support documentation from IPAs / Medical Groups as requested by the UM Nurses, Medical Directors or Management.
Processes Extensions and Denial Letters, when needed.
Prepares Utilization Review Reports as needed.
Assists the Case/Care Managers in coordinating and arranging services for members.
Provides assistance to the Claims Department, when requested.
Documents all patient specific information in appropriate information systems.
Assists in verifying health plan benefits and coordinating ambulatory services.
Reviews hospital admissions information and enter/update inpatient, SNF, home health and DME referrals as needed.
Prints and distributes daily census.
Seeks and accepts referrals for target patient populations, i.e. fragile seniors, catastrophic and transplant cases, frequent utilizer of ER and inpatient services, and patients diagnosed with specific diseases (cancer, asthma, COPD, AIDS, etc.).
Acts as a liaison, captures information and documents all patients referred to the ACM/disease state management programs.
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.
Qualifications
Education:
High school diploma/GED required.
Experience:
One (1) year of healthcare experience, a general knowledge of medical terminology and experience with community resources and social supports required. One (1) year of utilization management or managed care experience preferred.
About Us
Cedars-Sinai is a leader in providing high-quality healthcare encompassing primary care, specialized medicine and research. Since 1902, Cedars-Sinai has evolved to meet the needs of one of the most diverse regions in the nation, setting standards in quality and innovative patient care, research, teaching and community service. Today, Cedars- Sinai is known for its national leadership in transforming healthcare for the benefit of patients. Cedars-Sinai impacts the future of healthcare by developing new approaches to treatment and educating tomorrow's health professionals. Additionally, Cedars-Sinai demonstrates a commitment to the community through programs that improve the health of its most vulnerable residents.
About the Team
With a growing number of primary urgent and specialty care locations across Southern California, Cedars-Sinai’s medical network serves people near where they live. Delivering coordinated, compassionate healthcare you can join our network of clinicians and physicians to improve the healthcare people throughout Los Angeles and beyond.
Req ID : 4556
Working Title : Case Management Coordinator - Inpatient Specialty Program
Department : MNS ISP
Business Entity : Cedars-Sinai Medical Center
Job Category : Patient Services
Job Specialty : Case Management
Overtime Status : NONEXEMPT
Primary Shift : Day
Shift Duration : 8 hour
Base Pay : $22.79 - $34.19
Cedars-Sinai is an EEO employer. Cedars-Sinai does not unlawfully discriminate on the basis of the race, religion, color, national origin, citizenship, ancestry, physical or mental disability, legally protected medical condition (cancer-related or genetic characteristics or any genetic information), marital status, sex, gender, sexual orientation, gender identity, gender expression, pregnancy, age (40 or older), military and/or veteran status or any other basis protected by federal or state law.
-
Case Management Coordinator
4 weeks ago
Beverly Hills, California, United States Cedars-Sinai Full timeJob DescriptionThe Case Management Coordinator provides support to the utilization review process. The coordinator works collaboratively with all team members of Utilization Management, Patient and Provider Services, Claims Department and other Care Coordination Department staff. In addition, the coordinator assists in identifying, tracking and coordinating...
-
Personal Injury Case Coordinator
3 days ago
Beverly Hills, California, United States Omega Law Group PC Full timeJob DescriptionPosition Overview:Join Omega Law Group, a distinguished personal injury law firm dedicated to advocating for individuals affected by negligence and wrongful acts. As a Personal Injury Case Coordinator, you will play a pivotal role in supporting clients throughout their journey in the personal injury claims process. Your efforts will directly...
-
Case Manager
2 months ago
Beverly Hills, United States Direct Counsel, LLC Full timeDirect Counsel is seeking two Bilingual Case Managers to join a boutique law firm located in Los Angeles, CA. As a Case Manager you must be highly organized and able to work on a varied caseload. The Case Manager will assist the attorney in developing settlements, preparing documents and correspondence as needed. The ideal candidate is customer focused and...
-
Case Manager
3 weeks ago
Beverly Hills, United States Direct Counsel, LLC Full timeJob DescriptionJob DescriptionDirect Counsel is seeking two Bilingual Case Managers to join a boutique law firm located in Los Angeles, CA. As a Case Manager you must be highly organized and able to work on a varied caseload. The Case Manager will assist the attorney in developing settlements, preparing documents and correspondence as needed. The ideal...
-
Case Manager
5 months ago
Beverly Hills, United States Direct Counsel, LLC Full timeJob DescriptionJob DescriptionDirect Counsel is seeking two Bilingual Case Managers to join a boutique law firm located in Los Angeles, CA. As a Case Manager you must be highly organized and able to work on a varied caseload. The Case Manager will assist the attorney in developing settlements, preparing documents and correspondence as needed. The ideal...
-
Case Management Specialist
19 hours ago
Beverly Hills, California, United States Direct Counsel, LLC Full timeJob Summary:Direct Counsel, LLC is seeking a highly organized and detail-oriented Client Advocate Coordinator to join our team. As a key member of our staff, you will be responsible for managing a varied caseload and providing exceptional support to our attorneys and clients.Responsibilities:Develop and maintain strong relationships with clients, insurance...
-
Case Manager
3 months ago
Beverly Hills, United States Beverly Hills Injury Firm Full timeJob DescriptionJob DescriptionLocation: 9454 Wilshire Blvd. 6th Floor - Beverly Hills, CA.Beverly Hills Injury Firm (BHIF) is a prominent personal injury law firm seeking Case Managers & Medical Records Coordinators. BHIF maintains a friendly environment for all staff members. We know that our employees are the pillars of our ongoing success. We value our...
-
Case Manager
2 months ago
Beverly, United States NFI Massachusetts Full timeNFI Massachusetts, Inc., a non-profit human services organization, is currently seeking a full-time Case Manager for its residential youth program located in Beverly, MA. The Case Manager directly assists the clinicians with a variety of functions. This includes but is not limited to scheduling of treatment team meetings, communication with school districts...
-
Case Manager
1 month ago
Beverly Hills, United States Omega Law Group PC Full timeJob DescriptionJob Description**Please note that we kindly request no calls to our office regarding questions about job openings. For any inquiries, please email us at careers@omegalaw.com.**Omega Law Group is a prestigious personal injury law firm located in the heart of Beverly Hills. We are committed to championing the rights of individuals who have...
-
Case Manager
7 days ago
Beverly Hills, United States Omega Law Group PC Full time $25 - $35Job DescriptionJob Description**Please note that we kindly request no calls to our office regarding questions about job openings. For any inquiries, please email us at careers@omegalaw.com.**Omega Law Group is a prestigious personal injury law firm located in the heart of Beverly Hills. We are committed to championing the rights of individuals who have...
-
Case Manager Utilization RN-Per Diem
5 days ago
Beverly Hills, United States HealthEcareers - Client Full timeJob Summary: Works collaboratively with an MD to coordinate and screen for the appropriateness of admissions and Continued stays. Makes recommendations to the physicians for alternate levels of care when the patient does not meet the medical necessity for Inpatient hospitalization. Interacts with the family, patient and other disciplines to coordinate a...
-
Case Manager Assistant
1 month ago
Beverly Hills, United States Law Brothers Full time $23 - $30We are seeking a bilingual (English/Spanish) assistant position that will work directly with our case managers in retrieving all necessary documents for new and existing cases. This is an entry level position in which we will provide training upon hire. Specific responsibilities may vary depending on the assigned task needed. Core duties and responsibilities...
-
Case Manager
1 month ago
Beverly, United States Encompass Health Full timeHiring for all positions full-time, part-time, Baylor, and PRN Framingham location Hourly rate range $29. 00 - $45. 00 / hour Excellent PRN rates as well Compensation will be determined based on years of experience and applicable certifications. Recognized for your abilities as a Case ManagerAre you ready for a Case Management role that brings your career...
-
Case Manager
1 month ago
Beverly, United States Encompass Health Full timeHiring for all positions full-time, part-time, Baylor, and PRN Framingham location Hourly rate range $29. 00 - $45. 00 / hour Excellent PRN rates as well Compensation will be determined based on years of experience and applicable certifications. Recognized for your abilities as a Case ManagerAre you ready for a Case Management role that brings your career...
-
Case Manager
3 weeks ago
Beverly, United States Encompass Health Full timeHiring for all positions full-time, part-time, Baylor, and PRN Framingham location Excellent PRN rates as well Compensation will be determined based on years of experience and applicable certifications. Recognized for your abilities as a Case ManagerAre you ready for a Case Management role that brings your career closer to home and heart? Join Encompass...
-
Case Manager
1 week ago
Beverly, United States Encompass Health Full timeHiring for all positions full-time, part-time, Baylor, and PRN Framingham location Excellent PRN rates as well Compensation will be determined based on years of experience and applicable certifications. Recognized for your abilities as a Case ManagerAre you ready for a Case Management role that brings your career closer to home and heart? Join Encompass...
-
Personal Injury Case Manager
3 months ago
Beverly Hills, United States Law Brothers Full time $28 - $35Our firm is seeking a is a bilingual (English/Spanish) Case Manager to handle personal injury case files. You must have prior personal injury case management experience along with being able to handle a case file from intake to settlement or litigation to be considered for this position. A case manager is responsible for assisting clients in gathering all...
-
Director of Case Management
1 month ago
Beverly, United States CareOne Full timeJob Description Balance Life & Work with a New Career Opportunity (LONG TERM CARE)(SHORT TERM REHAB)(SKILLED NURSING) Now Hiring - Case Manager - Beverly, MA 01915Care One at Essex Park The Case Manager responsibilities will include, but are not limited to: Oversees the care provided to patients insured by Managed Care organizations, ensuring they receive...
-
Bilingual Case Manager Assistant
4 weeks ago
Beverly Hills, United States Omega Law Group PC Full timeJob DescriptionJob Description**Please note that we kindly request no calls to our office regarding questions about job openings. For any inquiries, please email us at careers@omegalaw.com .**Omega Law Group is a prestigious personal injury law firm located in the heart of Beverly Hills. We are committed to championing the rights of individuals who have...
-
Personal Injury Case Manager
5 months ago
Beverly Hills, United States Direct Counsel, LLC Full timeJob DescriptionJob DescriptionWe are currently seeking experienced Bilingual Case Managers to join an excellent boutique law firm located in Beverly Hills, CA. As a leading firm in personal injury law, the firm is committed to providing their clients with the highest level of service, and they need someone who shares their dedication and enthusiasm. The firm...