Case Manager-Utilization Management

Prime Healthcare•Sherman Oaks, CA

1d•Onsite

About The Position

Encino Hospital Medical Center is a 150-bed state-of-the-art hospital located in Encino, California. Its multi-disciplinary staff consists of 330 physicians and 520 professional support staff. Encino Hospital Medical Center serves a diverse population and incorporates elements of urban and suburban medicine in a caring environment. It offers a wide array of inpatient and outpatient services. The hospital is consistently at the forefront in providing innovative and integrated healthcare. Join an award-winning team of dedicated professionals committed to our core values of quality, compassion and community! Encino Hospital Medical Center, a member of the Prime Healthcare Foundation, offers incredible opportunities to expand your horizons and be part of a community dedicated to making a difference. Encino Hospital Medical Center offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. This is a fast-paced work environment in which you can take pride in serving an underserved community. Come Join a Team of Dedicated Healthcare Workers!!!

Requirements

BSW or other bachelor's degree in a related field.
At least one year experience in case management, discharge planning or nursing management; or Experience and knowledge in basic to intermediate computer skills.

Nice To Haves

Minimum 5 years of acute care experience preferred.
CCM or obtained within 1year
Current BCLS certificate preferred.
Knowledge of Milliman Criteria and InterQual Criteria preferred.

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.