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Director - Care Management

Company: Cedars-Sinai
Location: Beverly Hills
Posted on: September 12, 2020

Job Description:

Important update: In response to the current health situation, some of our hiring processes have changed. Read more …

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The Director is responsible for the overall management and development of network caremanagement and social work functions for Cedars-Sinai Medical Group andCedars-Sinai Health Associates. Theincumbent will research, develop and recommend program and departmentstrategies to serve our most needy patient population. Serves as a centralresource to senior executive team concerning strategies which are patientcentered, efficient, effective, and support financial budgets. Is responsiblefor making sure current policies and procedures are based upon currentstandards of care and legislative/regulatory requirements. This position will provide technical supportand expertise to case management and social workers to aide in solving complexpatient care management issues. The director of care management will also haveoversight of our Cedars-Sinai Medical Provider Network for Workers'Compensation.

The Director isresponsible for maintaining compliance with all MNS UM-related health planaccreditation and other regulatory requirements as outlined by NCQA, DMHC, HCFAand the Department of Insurance.

Education:

Bachelor's degree in Nursing required.  Master's degreein Nursing preferred.

License/Certification/Registration:

CA RN license required. Certified CareManager (CCM) highly preferred.

Experience:

- Three (3) years managementexperience in healthcare field, managed care experience and care managementexperience required.

- Three (3) years extensivetechnical and medical knowledge of disease categories and the usual servicesprovided in ambulatory and institutional setting.

- Three (3) years musthave a thorough knowledge of Utilization and Care Management, referrals processand managed care operational and contractual concepts and issues.

- Three (3) years excellentanalytical, interpersonal and organizational skills.

- Three (3) years excellentoral and written skills.

- Three (3) years knowledgeableand able to use standard computer software packages.

Working Title: Director - Care Management

Cedars-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. If you need a reasonable accommodation for any part of the employment process, please contact us by email at Applicant_Accommodation@cshs.org and let us know the nature of your request and your contact information. Requests for accommodation will be considered on a case-by-case basis. Please note that only inquiries concerning a request for reasonable accommodation will be responded to from this email address.

Cedars-Sinai will consider for employment qualified applicants with criminal histories, in accordance with the Los Angeles Fair Chance Initiative for Hiring.

At Cedars-Sinai, we are dedicated to the safety, health and wellbeing of our patients and employees. This includes protecting our patients from communicable diseases, such as influenza (flu). For this reason, we require that all new employees receive a flu vaccine based on the seasonal availability of flu vaccine (typically during September through March each year) as a condition of employment, and annually thereafter as a condition of continued employment.

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