Case Management Coordinator

4 weeks ago

Beverly Hills, California, United States Cedars-Sinai Full time

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 : $ $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.


  • Personal Injury Case Coordinator

    4 days ago

    Beverly Hills, California, United States Omega Law Group PC Full time

    Job 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...

  • Personal Injury Case Manager

    4 days ago

    Beverly Hills, California, United States Law Brothers Full time

    About Us Led by Shawn and Shervin Lalezary, the Law Brothers represent California's injured and have recovered more than $400 Million for their clients over the years. With offices throughout the state, the Law Brothers employ a team of skilled personal injury professionals and work with a large network of California's trusted legal support staff, medical...

  • Experienced Case Manager for Personal Injury Law

    1 week ago

    Beverly Hills, California, United States Razi Law Group A Professional Law Full time

    Position OverviewThis role is situated within a prominent personal injury law firm. The position is full-time and requires in-person attendance.We are in search of a **Senior Case Manager** who possesses a strong background in managing personal injury claims. The ideal candidate should have a minimum of **two years** of relevant experience.**Key...

  • Laundry Coordinator

    1 month ago

    Beverly Hills, California, United States HSH Management Services Full time

    Working alongside the Laundry Manager at The Peninsula Beverly Hills, we are seeking a Laundry Coordinator who possesses great attention to detail with a genuine warmth and sense of hospitality. Work for an award-winning luxury hotel group Learn and grow within a diverse multi-outlet property Exceptional benefits package Key AccountabilitiesFriendly demeanor...

  • Traveling RN Case Manager Position

    1 week ago

    Beverly Hills, California, United States Anders Group Full time

    Position OverviewAnders Group is actively seeking a travel nurse specializing in Case Management for an exciting opportunity. Job Details:Specialty: Case ManagementDiscipline: RNDuration: 13 weeksHours: 36 hours per weekShift: 12-hour daysEmployment Type: TravelCompensation is based on a 12-hour shift schedule and 36 hours per week, with a tax-free stipend...

  • Traveling RN Case Manager Position

    4 days ago

    Beverly Hills, California, United States Anders Group Full time

    Position OverviewAnders Group is actively seeking a dedicated travel nurse specializing in Case Management for an exciting opportunity. Job Details: - Specialty: Case Management - Discipline: RN - Duration: 13 weeks - Hours: 36 hours per week - Shift: 12-hour days - Employment Type: TravelAs a travel nurse with Anders Group, you will receive a competitive...

  • Travel RN Case Manager Position

    1 week ago

    Beverly Hills, California, United States Anders Group Full time

    Position OverviewAnders Group is actively seeking a travel nurse specializing in Case Management for an exciting opportunity. Job Details:Specialty: Case ManagementDiscipline: RNDuration: 13 weeksHours: 36 hours per weekShift: 12-hour daysEmployment Type: TravelThe pay package is structured around 12-hour shifts and 36 hours weekly, with a tax-free stipend...

  • Travel RN Case Manager Position

    1 week ago

    Beverly Hills, California, United States Anders Group Full time

    Position OverviewAnders Group is actively seeking a dedicated travel nurse specializing in Case Management for an exciting opportunity. Job Details:Specialty: Case ManagementDiscipline: RNEmployment Type: TravelWeekly Hours: 36 hoursShift: 12-hour daysCompensation Package:The pay package is structured around 12-hour shifts and 36 hours per week, with a...

  • Traveling RN Case Manager Position

    3 days ago

    Beverly Hills, California, United States Anders Group Full time

    Position OverviewAnders Group is actively seeking a skilled travel nurse specializing in Case Management for an exciting opportunity. Job Details:Specialty: Case ManagementDiscipline: RNDuration: 13 weeksHours: 36 hours per weekShift: 12-hour daysEmployment Type: TravelThe pay package is structured around 12-hour shifts and 36 hours per week, with a tax-free...

  • Personal Injury Legal Coordinator

    4 days ago

    Beverly Hills, California, United States Jobot Full time

    Position Overview:This role is for a dedicated and skilled Legal Assistant specializing in Personal Injury law. The ideal candidate will provide essential support to a team of attorneys in a dynamic and fast-paced legal environment.About the Firm:Our client is a well-regarded personal injury law firm known for its commitment to client advocacy and...

  • Personal Injury Case Intake Supervisor

    1 week ago

    Beverly Hills, California, United States SEDAGHAT LAW GROUP APC Full time

    Job OverviewBenefits:Free Parking401(k) Plan401(k) Matching ContributionsPerformance-Based BonusesHealth Insurance CoveragePaid Time OffA reputable and expanding plaintiff personal injury law firm is in search of a Case Intake Supervisor for our Intake Division. Ideal candidates should demonstrate reliability and a commitment to long-term employment. Strong...

  • People and Culture Coordinator

    1 month ago

    Beverly Hills, California, United States HSH Management Services Full time

    Formerly known as Human Resources, the People & Culture Team at The Peninsula Beverly Hills is seeking a Part-Time People & Culture Coordinator who possesses a genuine warmth and sense of hospitality. Work for an award-winning luxury hotel group Learn and grow within a diverse multi-outlet property Key AccountabilitiesStrong communication skills with a...

  • Personal Injury Legal Coordinator

    1 week ago

    Beverly Hills, California, United States Jobot Full time

    About the Position:This opportunity is for a dedicated and skilled Legal Assistant to provide essential support within a thriving personal injury law firm. Salary: $75,000 - $100,000 per yearAbout Us:Our firm is recognized for its excellence in personal injury law, boasting a team of award-winning attorneys and a supportive work environment.Key...

  • Legal Marketing and Intake Coordinator

    4 days ago

    Beverly Hills, California, United States Law Office of Shaun Setareh Inc Full time

    Job OverviewAbout UsLAW OFFICE OF SHAUN SETAREH INC is a distinguished and highly regarded law firm specializing in class-action and intricate litigation matters. We are at the leading edge of innovative wage-and-hour law, shaping the legal landscape in complex cases. Our firm is recognized as a leader in our field, with high-profile cases that consistently...

  • Personal Injury Case Intake Supervisor

    3 days ago

    Beverly Hills, California, United States SEDAGHAT LAW GROUP APC Full time

    Job OverviewA reputable and expanding plaintiff personal injury law firm is seeking a dedicated Intake Manager for our Intake Department. The ideal candidate will be reliable, possess exceptional customer service skills, and demonstrate strong communication and listening abilities. This role involves engaging with prospective clients via phone, collecting...

  • Spa Coordinator

    1 month ago

    Beverly Hills, California, United States HSH Management Services Full time

    Working alongside the Spa Director at The Peninsula Beverly Hills, we are seeking a Spa Coordinator (Full-Time) who possesses a genuine warmth and sense of hospitality. • Work for an award-winning luxury hotel group• Learn and grow within a diverse multi-outlet property• Exceptional benefits packageKey Accountabilities• Strong communication skills...

  • Personal Injury Case Intake Supervisor

    1 week ago

    Beverly Hills, California, United States SEDAGHAT LAW GROUP APC Full time

    Job OverviewBenefits:Free Parking401(k) Plan401(k) Matching ContributionsPerformance-Based BonusesHealth Insurance CoveragePaid Time OffA reputable and expanding plaintiff personal injury law firm is actively seeking a Case Intake Supervisor for our Intake Division. The ideal candidate will demonstrate reliability and a commitment to long-term employment....

  • Patient Care Management RN

    1 week ago

    Beverly Hills, California, United States National Guard Employment Network Full time

    Job Overview ATTENTION MILITARY AFFILIATED JOB SEEKERS - Our organization collaborates with partner companies to identify qualified candidates for their available positions. This opportunity is open to Veterans, Transitioning Military, National Guard and Reserve Members, Military Spouses, Wounded Warriors, and their Caregivers. If you possess the necessary...

  • Case Management

    1 month ago

    Woodland Hills, California, United States Blue Shield of California Full time

    Your RoleThe Care Managementteam will serve to support the mission of the department, which is to provide support to patients in maintaining health and wellness in the outpatient setting. The Nurse Consultant will report to the Manager of Care Management for the Population Health Management Medi-Cal Team. In this role, you will ensure that services are...

  • Client Services Coordinator

    1 week ago

    Beverly Hills, California, United States Beverly Hills Injury Firm Full time

    Job OverviewPosition: Client Services CoordinatorLocation: Beverly Hills, CABeverly Hills Injury Firm (BHIF) is a distinguished personal injury law practice dedicated to providing exceptional support to our clients. We foster a welcoming atmosphere for all team members, recognizing that our staff are the foundation of our success. Our attorneys, with a...