Coordinator - Case Management

Prime Healthcare•Inglewood, CA

1d•Onsite

About The Position

At Centinela Hospital Medical Center, our dedicated team of professionals are committed to our core values of quality, compassion, and community. As a member of Prime Healthcare, a Top-15 hospital system in the United States, Centinela Hospital Medical Center is actively seeking new members to join its award-winning team! Centinela Hospital Medical Center has been serving the communities of Inglewood and the wider Los Angeles area for 100 years. An award-winning facility, ranking in the top 5% nationally for quality and patient safety, Centinela Hospital is a 362-bed acute-care hospital with a 24-hour STEMI certified emergency department and primary stroke center, orthopedic care, advanced cardiac services, critical care services, inpatient and outpatient rehab programs, and more. Centinela has earned hundreds of national awards and recognitions, including "100 Top Hospital" recognition from Fortune/Merative and straight 'A's (2018-2024) for hospital safety from The Leapfrog Group. For more information, visit www.centinelamed.com .

Requirements

Knowledge of Utilization Management / Case Management terminology and functions, in both managed care and non-managed care environments.
Experience with Windows, Word and Excel, and data entry.

Responsibilities

Responsible for the coordination of the various activities of the Case Management Department including utilization management, social services and discharge planning.
Assists with case management referrals, authorizations and discharge planning.
Maintains and coordinates Medi-Cal (TARS) for presentation to on-site reviewer and files them accordingly.
Responsible for copying and sending charts for MEDICAL appeals.
Work closely with the business office in completing the retrospective TAR and maintain the DNFB log.
Assist in compiling reports and statistical data for the utilization committee and weekly utilization meetings.