LVN- Case Manager - Ambulatory Care - Hybrid

LVN
- Case Manager - Ambulatory Care - Hybrid

Beverly Hills, CA, United States

Primary duties and responsibilities include the following:

• 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. Use Milliman and Interqual guidelines as necessary.
• Begins discharge planning and care assessment within one working day (preferably on the day of admission).
• Submits 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 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.
• Coordinates discharge planning and alternative treatment plans with PCP/hospitalist/specialist as appropriate.
• Coordinates 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 scheduling 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 secures appointments with various CSMNS disease management programs.
• Enters and updates all authorization and clinical information into Nautilus (Access Express) no later than the date of discharge.

Benefits include health and dental insurance, vacation, and a 403(b) plan.

• Completion of an accredited Vocational Nurse program.

• Valid CA LVN license required.

• 1+ years of LVN experience preferred.

• Job Identification: 16811
• Legal
  
  Employer:
  
  Cedars-Sinai Medical Center
• Department: CSMC 8714016 MNS Ambulatory Care Mgmt
• Job Category:
  Patient Services
• Job Function:
  Case Management
• Locations: 8501 Wilshire Blvd, Beverly Hills, CA, 90211, US