Cedars-Sinai Medical Center

Posted 10 months ago

Listing Type: Nursing
Employment Type: Nursing
Shift: Days
Education Level: BSN Required
Certificates: Not Stated
Experience Level: All|Experienced
Compensation: NA

Cedars-Sinai is an Equal Opportunity Employer that welcomes and encourages diversity in the workplace.

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Requisition #: M12232

Working Title: Case Manager - LVN

Business Entity: MDN - Medical Delivery Network

Cost Center # - Cost Center Name: 0875150 - MNS UR/CM

City: Beverly Hills

Job Category: Allied Health/Clinical

Job Specialty: Other Allied Health

Position Type: Regular-F/T

Shift Length: 8hr

Hours: 8:00am - 5:00pm

Days: Monday - Friday

Shift Type: Day

Weekends: None

Job Posting: UM/Medical Management Clinical Nurse is responsible for working with the interdisciplinary care teams to ensure appropriate and consistent administration of plan benefits to pre and/or retro authorize services, assess medical necessity and appropriateness of treatment setting by applying appropriate medical policies, clinical guidelines, plan benefits, and/or scripted algorithms within scope of licensure. The UM/MM Clinical Nurse collaborates with provider offices and care management to promote the most appropriate, highest quality and effective use of clinical services to ensure quality member outcomes, and to optimize member benefits. This position is also responsible with optimization and integration of departments (ie: network management), training/development, resource management, as it may relate to the needs of the respective providers/offices they are assigned to. The position is also responsible in directing the activities of the Medical Management/UM Coordinator in order to fulfill the business needs and initiatives of the department.

Qualification Requirements/Preferences:
Education Certifications/Licensure Experience Physical Abilities MINIMUM JOB REQUIREMENTS/COMPETENCIES:
Requires a LVN with valid unrestricted license in the state of California
AS/BS in nursing and/or Health or Human Services Field; preferred
Certification as a Case Manager (CCM), Utilization Review, Managed Care or similar; desired
Minimum 3 years of clinical (experience in a hospital or urgent care environment a plus) or utilization review experience; managed care experience; preferred or any combination of education and experience, which would provide an equivalent background.
PHYSICAL DEMANDS:
Ability to sit in front of and operate a computer and other essential office equipment for extended period of time.
Ability to bend, lift, and carry objects of varying size weighing up to 25 pounds
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

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Cedars-Sinai is an EEO employer.  Cedars-Sinai does not unlawfully discriminate on the basis of 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, 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.

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Thea Bruzdzinski
Thea Bruzdzinski


Cedars-Sinai Medical Center

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Norma Pringle, sHRBP, HRC
Norma Pringle, sHRBP, HRC


Cedars-Sinai Medical Center

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Susan Williams
Susan Williams


Cedars-Sinai Medical Center

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Olivia Saavedra
Olivia Saavedra


Cedars-Sinai Medical Center

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