Job Description

When the work you do every single day has a crucial impact on the lives of others, every effort, every detail, and every second matters.

This shared culture of happiness, passion, and dedication pulses through Cedars-Sinai, and it’s just one of the many reasons why we rank as one of the top hospitals in the nation by U.S. News World Report.

Cedars-Sinai Medical Center is an organization known nationally for excellence in cancer treatment, research, and education.

We are seeking a highly motivated Administrative Assistant to provide administrative support and contribute to our mission of providing word-class health care and the best quality service to our patients and communities. We invite you to consider this exciting opportunity and provide us with an opportunity to learn more about you and your skills!

What will you be doing in this role?

The Utilization Review Case Manager validates the patient's placement to be at the most appropriate level of care based on nationally accepted admission criteria. The UR Case Manager uses medical necessity screening tools, such as InterQual or MCG criteria, to complete initial and continued stay reviews in determining appropriate level of patient care, appropriateness of tests/procedures and an estimation of the patient's expected length of stay. The UR Case Manager secures authorization for the patient's clinical services through timely collaboration and communication with payers as required. The UR Case Manager follows the UR process as defined in the Utilization Review Plan in accordance with the CMS Conditions of Participation for Utilization

Qualifications

Educational Requirements:

Assoc. Degree/College Diploma Graduate of an accredited nursing program

Bachelor's Degree Nursing

Licenses:

RN State License

Basic Life Support (BLS)

Experience:

3 years In acute nursing

2 years Case Management/Utilization Management

1 year CPT coding

Physical Demands:

Lifting 50 lbs. Carrying 50 lbs. Pushing 75 lbs. Pulling 75 lbs. Balancing, Stooping, Kneeling, Crouching, Reaching, Handling, Grasping, Feeling, Talking, Hearing, Repetitive Motions, Eye/Hand/Foot Coordination

Req ID : 7058

Working Title : Registered Nurse - Utilization Management - Per Diem 8 Hour Days

Department : Utilization Management

Business Entity : Cedars-Sinai Medical Center

Job Category : Patient Services

Job Specialty : Case Management

Overtime Status : NONEXEMPT

Primary Shift : Day

Shift Duration : 8 hour

Base Pay : $67.50 - $70.00

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.