$10K Sign-On Bonus - Registered Nurse - Utilization Review Case Manager
Company: CEDARS-SINAI
Location: Los Angeles
Posted on: May 28, 2023
Job Description:
Are you ready to bring your expert clinical skills to a
world-class facility recognized as one of the top ten in the United
States? Do you have a passion for the highest quality and patient
happiness? Then please respond to this dynamic opportunity
available with one of the best places to work in Southern
California! We would be happy to hear from you. When the work you
do every single day has a crucial impact on the lives of others,
every effort, every detail, and every second matters. This shared
culture of happiness, passion and dedication pulses through
Cedars-Sinai, and it's just one of the many reasons we've achieved
our fifth consecutive Magnet designation for nursing excellence.
From working with a team of dedicated healthcare professionals to
using state-of-the-art facilities, you'll have everything you need
to do something incredible-for yourself, and for others. Join us,
and discover why U.S. News & World Report has named us one of
America's Best Hospitals. Summary of Essential Duties:
- Validate patients' placement to be at the most appropriate
level of care based on nationally accepted admission criteria
- Use medical necessity screening tools, such as InterQual or MCG
criteria, to complete initial and continued stay reviews in
determining appropriate level of patient care, appropriateness of
tests/procedures and an estimation of the patient's expected length
of stay
- Secure authorization for clinical services through timely
collaboration and communication with payers as required
- Follow the UR process as defined in the Utilization Review Plan
in accordance with the CMS Conditions of Participation for
Utilization Review
- Collaborate with Care Coordinators to identify and follow up on
Observation class patients
- Follow up with the payer to verify approval/authorization of
the hospital stay (all dates of services)
- Function as an advocate, and contact person for the care team,
patient/family when communicating with payers, and or outside
agencies to ensure continuity of care, optimal clinical resource
outcomes, and appropriate financial management for the patient and
the organizationThis is an on-site position that requires the
employee to work in our office located at 6500 Wilshire Blvd. Los
Angeles, CA 90048#Jobs Education:
- Graduate of an accredited nursing program required
- BSN preferredLicense/Certification:
- Current, unrestricted California RN license required
- American Heart Association or American Red Cross BLS
requiredExperience:
- A minimum of 3 years of acute care nursing experience
required
- 2+ years of case management experience preferred
- Knowledge of medical literature, research methodology, health
care delivery systems and financial reimbursement requiredKeywords:
RN, Registered Nurse, Case Manager, Utilization Review, Utilization
Management, Healthcare, Medical Center, Hospital, Los Angeles, CA,
California Working Title: $10K Sign-On Bonus - Registered Nurse -
Utilization Review Case ManagerDepartment: Utilization
ManagementBusiness Entity: Cedars-Sinai Medical CenterJob Category:
Patient ServicesJob Specialty: Case ManagementPosition Type:
Full-timeShift Length: 8 hour shiftBase Pay:$50.98 - $81.57
Keywords: CEDARS-SINAI, Los Angeles , $10K Sign-On Bonus - Registered Nurse - Utilization Review Case Manager, Executive , Los Angeles, California
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