Case Mgr

Responsibilities

BHC Alhambra Hospital

Medi-Cal Treatment Authorization Request (TAR) Coordinator – Per Diem 

Shift:

5 days per week

3:30 pm – 8:00 pm

Are you caring, compassionate and hardworking?

Apply today to join our amazing team

BHC Alhambra Hospital  is located in the beautiful city of Rosemead, California. Our 115 bed facility established in 1924 prides itself on upholding a standard of excellence that allows our patients to take the first step to recovery. BHC Alhambra Hospital is a private, fully accredited, full-service acute psychiatric hospital serving children, adolescents and adults. BHC Alhambra is dedicated to providing quality behavioral health, substance abuse, and eating disorder treatment. We offer inpatient, residential, partial hospitalization and intensive outpatient options for individuals in the communities of the San Gabriel Valley, Los Angeles County, and surrounding areas.

The Medi-Cal TAR Coordinator position is an exciting opportunity to gain fundamental experience with the essential elements of Case Management, Customer Service, and Business Office functions. This position is starting at 20-25 hours weekly with potential to grow into full time. This position is responsible for meeting the revised contractual obligations for the County of Los Angeles in compliance with state requirements of Authorization and Utilization Review, works within the Case Management Department and under supervision by the Director of Case Management/Utilization Review. This position requires the demonstration of organizational, problem-solving, technological, and critical-thinking skills to meet the daily clinical coordination needs of the authorization and utilization review process with BHC Alhambra Hospital.

Requirements:

Education: High School Diploma with some college preferred; or AA Degree in Liberal Arts or related field is preferred; or equivalent of training and experience in Business Office or Case Management is preferred.

Experience: Ability to work effectively with people of diverse backgrounds preferred. Knowledge and expertise in Microsoft Word, Excel, PowerPoint, computer and general office procedures, preferred. Successful completion of NCI training and must maintain a valid driver license or ID in applicable state within 90 days of employment.

Key Responsibilities include:

Create a daily census for Medi-Cal inpatients. List required documents on the Medi-Cal Census tool. Work with the Medical Record’s Director, the Case Manager, the Director of Case Management/Utilization Review, the Business Office Lead Medi-Cal Account Coordinator, Unit Managers, and the live medical record to gather documents that meet the state requirements for authorization of acute medical necessity, as well as resolve any barrier that may exist for any documentation submission. Hold staff members accountable for producing required documents for submission to the County of Los Angeles, making Director of Case Management/Utilization Review aware of barriers. List the collected documents on the Medi-Cal Census tool to compare with required submissions. Utilize the Medi-Cal Concurrent Cover Sheet, listing the enclosed documents to be submitted for patient authorization. Interface with the County of Los Angeles about meeting the daily state requirement of Utilization Review. Participate in daily telephonic coordination of care with the County of Los Angeles Administration and/or other staff members.

The ideal candidate is someone who demonstrates:

Ability to interact effectively with professional staff, hospital staff and others engaged in the medical/insurance field. Attention to details in monitoring for active treatment, medical necessity, and continued stay medical necessity of treatment documentation. Sense of urgency to gather essential documents for upload to Department of Mental Health secure website and submit through portal. Leadership skills to work cohesively within a multi-disciplinary environment to obtain essential documents and problem-solve as needed to accomplish tasks. The ability to be open a flexible to the needs of the business and changes that may occur. Strong professional presence and verbal skills to meet with patients and support system members to review required admission documents, insurance coverage, and facilitate payment arrangements. Strong professional presence and verbal skills to contact insurance carriers to verify patient benefits for treatment and advocate for patient care.

Your passion, inspiration, and talents are invaluable to us and our mission to serve others. Our facility can provide a place for you to thrive and continue your professional development.

Qualifications

BHC Alhambra Hospital employees receive great opportunities:

Tuition Assistance Challenging and rewarding work environment Career and growth opportunities Comprehensive Benefits Competitive Compensation & Generous Paid Time Off Excellent Medical, Dental, Vision and Prescription Drug Plans 401(K) with company match and discounted stock plan SoFi Student Loan Refinancing Program

About Universal Health Services

One of the nation’s largest and most respected providers of hospital and healthcare services, Universal Health Services, Inc. (UHS) has built an impressive record of achievement and performance. During the year, UHS was again recognized as one of the World’s Most Admired Companies by Fortune; and listed in Forbes ranking of America’s Largest Public Companies. Operating acute care hospitals, behavioral health facilities, outpatient facilities and ambulatory care access points, an insurance offering, a physician network and various related services located all over the , Washington, , Puerto Rico and the United Kingdom.

EEO Statement

All UHS subsidiaries are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants and teammates. UHS subsidiaries are equal opportunity employers and as such, openly support and fully commit to recruitment, selection, placement, promotion and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state or local laws. We believe that diversity and inclusion among our teammates is critical to our success.

Notice

At UHS and all our subsidiaries, our Human Resources departments and recruiters are here to help prospective candidates by matching skillset and experience with the best possible career path at UHS and our subsidiaries. We take pride in creating a highly efficient and best in class candidate experience. During the recruitment process, no recruiter or employee will request financial or personal information (Social Security Number, credit card or bank information, etc.) from you via email. The recruiters will not email you from a public webmail client like Hotmail, Gmail, Yahoo Mail, etc. If you are suspicious of a job posting or job-related email mentioning UHS or its subsidiaries, let us know by contacting us at:

---