LVN- Case Manager - Ambulatory Care - Hybrid

Job Description

Join Cedars-Sinai

Cedars-Sinai has been named to the Honor Roll for the ninth consecutive year and tied for #1 in California and Los Angeles in U.S. News & World Report's "Best Hospitals 2024-25" rankings, as well as placed among the very best in 11 specialties nationwide.

Align yourself with an organization that has a reputation for excellence! Cedars-Sinai was awarded the National Research Corporation's Consumer Choice Award 19 years in a row for providing the highest-quality medical care in Los Angeles. We were also awarded the Advisory Board Company's Workplace of the Year. This recognizes hospitals and health systems nationwide that have outstanding levels of employee engagement. Join us! Discover why U.S. News & World Report has named us one of America's Best Hospitals.

Why work here?

Beyond outstanding employee benefits including health and dental insurance, vacation, and a 403(b), we take pride in hiring the best employees. Our accomplished staff reflects the culturally and ethnically diverse community we serve. They are proof of our dedication to creating a dynamic, inclusive environment that fuels innovation.

Are you ready to bring your clinical proficiencies to a world-class Medical Group known for the very highest clinical standards? Do you have a passion for the highest quality and patient satisfaction? 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.

The Cedars-Sinai Medical Network is committed to helping primary care and specialist physicians provide excellent care to all their patients, who benefit from convenient access to primary and specialty care physicians and seamless coordination of care between them. As a part of Cedars-Sinai, our physicians and staff are partners in quality health care from a medical center that is consistently recognized as one of the finest hospitals in the country. For the 8th consecutive year, we have been named one of the top 20 Physician Groups in Southern California by Integrated Healthcare Associates (IHA).

Primary Duties and Responsibilities

• 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 day of admission).

• Submits necessary clinical information to the health plan using the accepted format (MIDAS or telephonic) and coordinate health plan communication with assigned hospitalist as appropriate.

• For patients who are transitioning to the 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 secure appointment with various CSMNS disease management programs

• Enters and updates all authorization and clinical information into Nautilus (Access Express) no later than date of discharge

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.