Lead RN Care Coordinator | Case Management & Review

Cedars-Sinai; Los Angeles (CA); On-site; USD 110,000 - 140,000; Full time

Job summary

Cedars-Sinai is seeking a Lead Care Coordinator (RN) to guide a clinical team in delivering timely, appropriate patient care. You will supervise a caseload, apply screening tools like InterQual/MCG, and support initial and ongoing reviews for optimal care levels and insurance authorization.

The role requires a nursing education background, state licensure in California, and several years in acute nursing and case management, ensuring adherence to utilization review policies and CMS guidelines.

Qualifications

• Bachelor's Degree in Nursing required.
• 3 years Acute Nursing experience required.
• 2 years Case Management experience required.
• RN license in California required.

Responsibilities

• Lead care coordination efforts across the patient care team.
• Oversee a manageable patient caseload and perform utilization reviews.
• Determine appropriate level of care and secure insurance authorization.
• Adhere to department Utilization Review Plan and CMS Participation requirements.

Skills

Leadership

Utilization review

InterQual/MCG criteria

Education

Bachelor's Degree in Nursing

Master's Degree in Nursing

Tools

InterQual

MCG criteria

Case Management process

Job description

Cedars-Sinai is seeking a Lead Care Coordinator (RN) to guide a clinical team in delivering timely, appropriate patient care. You will supervise a caseload, apply screening tools like InterQual/MCG, and support initial and ongoing reviews for optimal care levels and insurance authorization.

The role requires a nursing education background, state licensure in California, and several years in acute nursing and case management, ensuring adherence to utilization review policies and CMS guidelines.