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Director - Care Management

Requisition # 20000204 Apply Now

The Director is responsible for the overall management and development of network care management and social work functions for Cedars-Sinai Medical Group and Cedars-Sinai Health Associates. The incumbent will research, develop and recommend program and department strategies to serve our most needy patient population. Serves as a central resource to senior executive team concerning strategies which are patient centered, efficient, effective, and support financial budgets. Is responsible for making sure current policies and procedures are based upon current standards of care and legislative/regulatory requirements.  This position will provide technical support and expertise to case management and social workers to aide in solving complex patient care management issues. The director of care management will also have oversight of our Cedars-Sinai Medical Provider Network for Workers' Compensation.

The Director is responsible for maintaining compliance with all MNS UM-related health plan accreditation and other regulatory requirements as outlined by NCQA, DMHC, HCFA and the Department of Insurance.

Education:

Bachelor's degree in Nursing required. Master's degree in Nursing preferred.

 

License/Certification/Registration:

CA RN license required. Certified Care Manager (CCM) highly preferred.

 

Experience:

- Three (3) years management experience in healthcare field, managed care experience and care management experience required.

- Three (3) years extensive technical and medical knowledge of disease categories and the usual services provided in ambulatory and institutional setting.

- Three (3) years must have a thorough knowledge of Utilization and Care Management, referrals process and managed care operational and contractual concepts and issues.

- Three (3) years excellent analytical, interpersonal and organizational skills.

- Three (3) years excellent oral and written skills.

- Three (3) years knowledgeable and able to use standard computer software packages.

  • Working Title: Director - Care Management
  • Department: MNS ISP
  • Business Entity: Medical Network
  • City: Beverly Hills
  • Job Category: Clinical Operations
  • Job Specialty: Clinical Operations
  • Position Type: Full-time
  • Shift Length: 8 hour shift
  • Shift Type: Full-time
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Cedars-Sinai is an EEO employer. Cedars-Sinai does not unlawfully discriminate on the basis of the race, religion, color, national origin, citizenship, ancestry, physical or mental disability, legally protected medical condition (cancer-related or genetic characteristics or any genetic information), marital status, sex, gender, sexual orientation, gender identity, gender expression, pregnancy, age (40 or older), military and/or veteran status or any other basis protected by federal or state law. If you need a reasonable accommodation for any part of the employment process, please contact us by email at Applicant_Accommodation@cshs.org and let us know the nature of your request and your contact information. Requests for accommodation will be considered on a case-by-case basis. Please note that only inquiries concerning a request for reasonable accommodation will be responded to from this email address.

Cedars-Sinai will consider for employment qualified applicants with criminal histories, in accordance with the Los Angeles Fair Chance Initiative for Hiring.

At Cedars-Sinai, we are dedicated to the safety, health and wellbeing of our patients and employees. This includes protecting our patients from communicable diseases, such as influenza (flu). For this reason, we require that all new employees receive a flu vaccine based on the seasonal availability of flu vaccine (typically during September through March each year) as a condition of employment, and annually thereafter as a condition of continued employment.

About Our Location

Beverly Hills, California

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  • Clinical Operations, Beverly Hills, California, United StatesRemove