Case Management Coordinator - Ambulatory Case Management

CEDARS-SINAI; Beverly Hills (CA); On-site; USD 60,000 - 80,000; Full time

Job summary

Cedars-Sinai is seeking a Case Management Coordinator, Utilization Management, to provide support for the utilization review process and coordinate care across departments.

The role requires collaboration with Medical Directors, Providers, and care teams to ensure high-quality, cost-effective healthcare in compliance with state and federal guidelines.

Qualifications

• High School Diploma/GED required.
• 1 year Healthcare experience, a general knowledge of medical terminology and experience with community resources and social supports required.
• 1 year Previous utilization management or managed care experience; word processing spreadsheet skills also preferred

Responsibilities

• The Case Management Coordinator, Utilization Management, 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.

Skills

Healthcare experience

Medical terminology

Community resources

Social supports

Utilization management experience

Word processing

Spreadsheets

Education

High School Diploma/GED

Job description

Job Description

Are you ready to bring your clinical competencies to a world-class Medical Group known for the very highest clinical standards? Do you have a passion for the highest quality and patient satisfaction?

The Cedars-Sinai Medical Network is committed to helping primary care and specialist physicians provide excellent care to all their patients, who benefit from convenient access to primary and specialty care physicians and seamless coordination of care between them. As a part of Cedars-Sinai, our physicians and staff are partners in quality health care from a medical center that is consistently recognized as one of the finest hospitals in the country. For the 8th consecutive year, we have been named one of the top 20 Physician Groups in Southern California by Integrated Healthcare Associates (IHA).

Why work here?

Beyond outstanding benefits, competitive salaries and health and dental insurance we take pride in hiring the best, most passionate employees. Our talented staff reflects the culturally and ethnically diverse community we serve. They are proof of our dedication to creating a dynamic, inclusive environment that fuels innovation and the gold standard of patient care we strive for.

What will you be doing in this role?

The Case Management Coordinator, Utilization Management, 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 compliant with all state and federal regulations and guidelines.

Qualifications

Job qualifications

Education

• High School Diloma/GED required

Work Experience

• 1 year Healthcare experience, a general knowledge of medical terminology and experience with community resources and social supports required
• 1 year Previous utilization management or managed care experience; word processing spreadsheet skills also preferred preferred