Case Manager, RN or LVN – FT Days

Requisition # HRC1026715

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.

Qualifications:

Education:

• Graduate of an accredited nursing program required (LVN or RN)

License/Certifications:

• Current, unrestricted California LVN or RN license required
• BLS from the American Heart Association or American Red Cross
• Certified Case Manager (CCM) preferred

Experience:

• 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

Working Title:

Case Manager, RN or LVN – FT Days

Department:

MNS ISP

Business Entity:

Medical Network

Job Category:

,Patient Services,Patient Services

Job Specialty:

Case Management

Position Type:

Full-time

Shift Length:

8 hour shift

Shift Type:

Day

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. If you need a reasonable accommodation for any part of the employment process, please contact us by email at Applicant_Accommodation@cshs.org and let us know the nature of your request and your contact information. Requests for accommodation will be considered on a case-by-case basis. Please note that only inquiries concerning a request for reasonable accommodation will be responded to from this email address.

Cedars-Sinai will consider for employment qualified applicants with criminal histories, in accordance with the Los Angeles Fair Chance Initiative for Hiring.

At Cedars-Sinai, we are dedicated to the safety, health and wellbeing of our patients and employees. This includes protecting our patients from communicable diseases, such as influenza (flu) and COVID-19. For this reason, we require that all new employees receive a flu vaccine based on the seasonal availability of flu vaccine (typically during September through April each year) as a condition of employment, and annually thereafter as a condition of continued employment, subject to medical exemption or religious accommodation. For the same reason, you may also be required to receive other vaccines such as COVID-19 as a condition of employment. Cedars-Sinai reserves the right to make modifications to its required list of vaccines as required by law and/or policy.

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