LVN- Case Manager - Ambulatory Care - Hybrid

About the role

The Cedars-Sinai Medical Network is seeking a dedicated healthcare professional to join our team. We are a world-class Medical Group committed to providing excellent care to our patients through seamless coordination of care.

Responsibilities

• Meets with patients within 24 hours of admission and conducts an initial assessment.
• Consults with assigned hospitalist each day during morning rounds regarding disposition planning and appropriateness for each day of patient’s stay.
• Reviews with hospitalist the patient’s admission and continued stay for medical necessity, appropriateness of care and level of care. Uses Milliman and Interqual guidelines as necessary.
• Begins discharge planning and care assessment within one working day (preferably on day of admission).
• SUBMITSES necessary clinical information to the health plan using the accepted format (MIDAS or telephonic) and coordinates health plan communication with assigned hospitalist as appropriate.
• For patients who are transitioning to the Skilled Nursing Facilities, refers to nurse practitioner and case manager assigned to the SNF’s for continued review and follow up.
• AUTHORIZES all appropriate services based upon covered benefits and necessity of care provided.
• CORRELATES discharge planning and alternative treatment plans with PCP/hospitalist/specialist as appropriate.
• CORRELATES the patient’s care with other health care personnel to ensure that the patient receives care timely post discharge.
• SECURES outpatient follow-up appointments and schedules tests or outpatient procedures with appropriate health care providers.
• REFERS to Ambulatory Case Manager patients identified that will need oversight of outpatient care and compliance to avoid unnecessary readmissions.
• COORDINATES referrals and secure appointment with various CSMNS disease management programs.
• ENTERS and UPDATES all authorization and clinical information into Nautilus (Access Express) no later than date of discharge.

Requirements

Must have a current medical license and be eligible for licensure in the state of California.

Qualifications

Experience in hospital medicine is preferred.

Skills

Strong communication skills and the ability to work effectively in a multidisciplinary team setting are essential.

Benefits

We offer a comprehensive benefits package including health and dental insurance, vacation, and a 403(b) retirement plan.

Pay

Competitive salary commensurate with experience.

Schedule

Full-time position with flexible schedule to accommodate patient needs.