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.
As the Manager of Case Management, you will manage the day to day operations for the Care Coordination team and works closely with the interdisciplinary and administrative team to align care coordination operations with department and organizational goals and targets. The Manager, Case Management collaborates with the case management Medical Director as well as the utilization management team and social work leadership team. May have frequent contact with Nurse Executives and Directors, Quality Directors, Ancillary Services directors, finance department, Medical Directors, physicians, contracted providers, community resources as well as patients and family members.
Summary of Essential Duties:
Provides leadership and oversees supervisors, case management staff and resource personnel.
Reviews cases frequently with staff, acts as clinical consultant regarding care management issues, guides clinical staff with review of assessments and care plans and evaluates utilization reviews or documentation.
In conjunction with VP, Director and/or other leadership, coordinates, develops, and implements action plans to respond to areas in need of improvement related to patient flow and care coordination across the continuum.
Monitors required metrics, including but not limited to length of stay, readmissions, observation stays, avoidable delays; conducts documentation audits.
Participates in development and implementation of policies, workflows, processes.
Participates, develops and monitors performance improvement plans including key performance indicators.
Demonstrates and ensures knowledge of staff regarding medical necessity, regulatory requirements and standards, such as Joint Commission.
Utilizes demonstrated knowledge of acute case management, care coordination & discharge planning roles and responsibilities.
Coordinates the collaboration and integration of social services & care coordination functions.
Drives and supports change management for all initiatives.
Manages the effective utilization of human resources within care coordination, including, working with Supervisor to adjust staff assignments daily. Develops staffing plans in response to unscheduled sick-calls, vacation requests and other occurrences.
Bachelor's Degree in Nursing (BSN) required
Masters Degree in Nursing (MSN) preferred
Current, unrestricted California State Nursing License required
Case Management Certification preferred: Certified Case Manager (CCM), Accredited Case Manager (ACM), or ANCC Nurse Case Manager (RN-BC)
BLS from the American Red Cross or American Heart Association required
A minimum of 2 years leadership experience in acute care Case Management required
At least 3 years of experience and knowledge of InterQual and MCG Criteria, as well as utilization preferred
Keywords: Registered Nurse, RN, Manager, Case Manager, Care Coordinator, Care Coordination, Milliman, Interqual, Supervisor, Healthcare, Hospital, Medical Center, Los Angeles, CA, California
Providing healthcare for more than 100 years, Cedars-Sinai has evolved into one of the most dynamic and highly renowned medical centers in the world. Along with caring for patients, Cedars-Sinai is a hub for biomedical research and a training center for future physicians and other healthcare professionals. This attracts exceptional talent to Cedars-Sinai, including world-renowned physician-scientists who seek a place where they can both conduct research and see patients--the ideal formula for discovery and its translation into cures. Our patients benefit from access to doctors at the top of their fields, and our researchers have an ideal community in which to study the impact of healthcare challenges, and reflect that knowledge in their research. The greater Los Angeles area in which Cedars-Sinai resides possesses unparalleled cultural and ethnic diversity which offers outstanding opportunities for translational and clinical research and a dynamic environment for medical education.Although community based, Cedars-Sinai is a major t...eaching hospital affiliated with the David Geffen School of Medicine at the University of California, Los Angeles (UCLA). Cedars-Sinai has highly competitive graduate medical education programs in more than 50 specialty and subspecialty areas, a graduate program in biomedical sciences and translational medicine, a clinical scholars program directed towards junior physicians with aspirations to become clinical scientists, and post graduate training opportunities.There are more than 250 full-time faculty members at Cedars-Sinai. The voluntary medical staff, comprised of more than 2,200 specialty board-certified or board-qualified physicians, represent all of the specialties and subspecialties and collaborate with full-time medical staff in the teaching responsibilities of the graduate medical education programs.