Registered Nurse - Los Angeles, United States - Cedars-Sinai

    Cedars-Sinai
    Cedars-Sinai Los Angeles, United States

    2 weeks ago

    Cedars-Sinai background
    Description

    Job Description*Job Summary:

    Key Job Responsibilities
    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 Review.

    Qualifications
    Educational Requirements:

    Assoc.

    Degree/College Diploma Graduate of an accredited nursing programBachelor's Degree Nursing preferred
    Licenses:RN State LicenseBasic Life Support (BLS)
    Experience:3 years In acute nursing2 years Case Management preferred1 year CPT coding preferred

    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 : 1261
    Working Title :
    Registered Nurse
    • Utilization Management 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 : $ $83.
    95Cedars
    • 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.