Are you ready to bring your expert clinical competencies 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.
We are seeking an experienced, knowledgeable Per-Diem Utilization Review Case Manager to work directly in our Emergency Department, collaborating closely with Physicians to determine that most appropriate level of care for a diverse array of patients and medical conditions.
Summary of Essential Duties:
- As a Per-Diem Emergency Department Utilization Review Case Manager , you will use nationally accepted medical necessity screening tools, such as InterQual, MCG, or CMS 2 Midnight Rule admission criteria to validate correct patient class and level of care: critical, telemetry, acute, and observation, for emergency department admissions.
- Works collaboratively with ED Care Coordination, to assist the ED physicians with appropriate admission orders and supporting medical record documentation.
- Secures authorization for the patient's clinical services through timely collaboration and communication with payers as required.
- Follows the UR process as defined in the Utilization Review Plan in accordance with the CMS Conditions of Participation for Utilization Review.
The schedule for this position will be 7:00am - 7:30pm.
- Graduate of an accredited nursing program required
- BSN or MSN preferred
- Current, unrestricted California RN License required
- BLS from the American Heart Association or American Red Cross required
- Certified Case Management RN preferred
- A minimum of 5 years of acute care nursing experience required
- A minimum of 2 years of UR case management experience required
- At least 3 of years of ED nursing experience preferred
- Emergency Department Case Manager experience preferred
- Experience using Interqual or Milliman required
- High level of competency performing medical necessity reviews with accepted criteria required
Keywords: Registered Nurse, RN, Case Manager, Utilization, Emergency Room, Emergency Department, Per-Diem, Per Diem, Hospital, Medical Center, Healthcare, Los Angeles, CA, California
- Working Title: Registered Nurse - Per Diem Emergency Dept. UR Case Manager - 12-Hour Day Shift
- Department: Utilization Management
- Business Entity: Corporate Services
- City: Los Angeles
- Job Category: Family & Function, Corporate Services, Nursing
- Job Specialty: UNASSIGNED
- Position Type: Per Diem
- Shift Length: 12 hour shift
- Shift Type: Day
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.Apply NowApply Later