MEDICAL SERVICE COORDINATOR, CCS (Registered Nurse, Pediatrics - Case Management)

Los Angeles County (CA)•Los Angeles, CA

73d

About The Position

Determines medical eligibility of children referred to California Children Services and approves and coordinates treatment services for children accepted under the program.

Requirements

Two years' work experience as a registered nurse in case management OR two year's work experience as a registered nurse in a pediatric setting.
Case management is a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual's and family's comprehensive health needs through communication and available resources to promote quality, cost-effective outcomes.
A current active license to practice as a Registered Nurse issued by the California Board of Registered Nursing.
Applicants must ensure the License and Certification Section of the application is completed. Provide the title(s) of your required license and certificate, the number(s), date(s) of issue, date(s) of expiration and the name(s) of the issuing agency for the required license as specified in the Selection Requirements.
The required license and/or certificate must be active and unrestricted or your application will not be accepted.
A current certification issued by the American Heart Association's Basic Life Support (BLS) for Healthcare Providers (CPR & AED) Program.
Applicants MUST attach a legible photocopy of the required BLS certification to their application at the time of filing or within 15 calendar days of application submission send to [email protected]. Applications submitted without the required evidence of BLS certification will be rejected.
California Class C Driver License.

Nice To Haves

Additional years of experience beyond the selection requirements

Responsibilities

Evaluates referrals and requests for medical service made by physicians, parents, teachers, social workers, nurses and various agencies, considering the impact of varied diagnoses of medical maladies affecting children, the treatment generally required for the ailments and the guidelines for service, and makes determinations of medical eligibility and the type and extent of care proposed for California Children Services.
Approves requests by physicians for hospitalization of children, assisting in arrangements for hospitals not on approved list, and explains California Children Services regulations to physicians.
Determines whether physician's specialty is appropriate to the patient's condition and whether physicians are on State's approved panel.
Advises non-panel physicians on procedure for becoming approved.
Refers patients to specific medical specialists who have been certified by the State Department of Health, California Children Services.
Reviews medical reports and correspondence on assigned cases and coordinates the arrangements for approved medical services.
Participates in case conferences to evaluate treatment proposals and to provide interpretations regarding application of California Children Service policies.Reviews and authorizes requests for medical equipment and authorizes dispensing of supplies such as drugs, appliances, braces and visiting nurse services.
Determines medical eligibility of referrals for emergency hospitalization or diagnostic studies and expedites the processing of requests for treatment services requested over the telephone.
Based on the physician's plan of treatment for the patient, the coordinator's knowledge and the program guides, determines the amount of time that will be allotted for hospitalization and has authority to approve an extension of time for eligible services rendered.
Reviews each assigned case at least once yearly, requesting and evaluating current medical reports, and determines if medical services should be continued and orders closure when maximum benefits of treatment have been achieved.
Interprets program to physicians, parents, teachers, social workers and to agencies and provides general information concerning medical eligibility requirements and procedures.
Assists those not eligible in developing private or other plans for obtaining medical care.
Attends meetings that update eligibility guidelines and spell out the general conditions under which they will operate.
Reads professional journals and attends seminars and lectures to become informed on new developments relating to the function.