Case Manager - CHMC Utilization Management in Inglewood, CA at Centinela Hospital Medical Center

Date Posted: 11/2/2019

Job Snapshot

Job Description



Overview

****FULL TIME / DAYS SHIFT****

Responsibilities

Responsible for the quality and resource management of all patients that are admitted to the facility from the point of their admission and across the continuum of the health care management. Works on behalf of the advocate, promoting cost containment and demonstrates leadership to integrate the health care providers to achieve a perceived seamless delivery of care. The methodology is designed to facilitate and insure the achievement of quality, clinical and cost effective outcomes and to perform a holistic and comprehensive admission and concurrent review of the medical record for the medical necessity, intensity of service and severity of illness.

Qualifications

Education and Work Experience

  • Licensed clinician with a minimum 5 years of acute care experience preferred.

  • Grandfathered prior to April 1, 2015. Minimum 5 years’ post graduate of an accredited school of Social Work for Licensed Clinical Social Worker.

  • At least one-year experience in case management, discharge planning or management, preferred.

  • CCM obtained within 6 months with a minimum of 2 years’ experience.

  • Current BCLS (AHA) certificate, preferred.

  • Knowledge of Milliman Criteria and InterQual Criteria preferred.

  • Experience and knowledge in basic to intermediate computer skills.

  • Behavioral Violence Prevention Training within 3 months of hire and maintain current.

  • We are an Equal Opportunity/ Affirmative Action Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation or other protected characteristics. If you need special accommodation for the application process, please contact Human Resources. EEO is the Law: http://www1.eeoc.gov/employers/upload/eeoc_self_print_poster.pdf