Job Information
UCLA Health Utilization Management Intensive Case Management Coordinator - After Hours in Los Angeles, California
Description
Provide key clinical support within a world-class health organization. Help ensure the delivery of exceptional, compassionate, and appropriate patient care. Take your professional expertise to the next level. You can do all this and more at UCLA Health.
Under the direction and supervision of the RN Assistant Director, the Case Management Coordinator is responsible for patient high risk care coordination activities in hospital, SNF and outpatient settings during afterhours and weekends. The role receives urgent, routine, pre-service and retro authorization requests and processes them through the referral and authorization procedures as established by the medical group utilization department. Responsible for prepping and processing referrals according to DOFR, posted UCLA Medical Group Medical Guidelines, identifies documents needed to assist the next level of reviewer in review, and health plan contracts.
The Case Management Coordinator will also be responsible for:
Preparation and maintenance of specific reports and computer applications/logs
Monitoring members/patients followed by Case Management for safe discharge planning and appropriate access to care
Working directly with Concurrent Nurses and Intensive Case Management Nurses
Review pending claims for approval or denial
Provide timely care coordination for CM enrolled patients and Medicare Advantage high risk patients to prevent hospital utilization
Salary Range: $22.03 - $43.68 Hourly
Note: This posted position is 1 of 2 positions available for hire. All applicants will apply through this requisition and if selected will be hired into one of the available positions.Qualifications
We're seeking a well-organized, detail-oriented, deadline-driven individual with:
High school diploma, GED, or equivalent
Experience working in case management and care coordination in managed care environment preferred
Proficiency in processing ambulatory managed care referrals
Vodavi phone system experience desired
Ability to operate a wide variety of office equipment
Computer proficiency with Microsoft Office
Excellent communication and multi-tasking skills
Ability to work well with frequent interruptions and meet deadlines
Care Coordination experience preferred
UCLA Health welcomes all individuals, without regard to race, sex, sexual orientation, gender identity, religion, national origin or disabilities, and we proudly look to each person’s unique achievements and experiences to further set us apart.