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
Bachelor's degree in Nursing required. Master's degreein
CA RN license required. Certified CareManager (CCM) highly
- 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
- 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
- Three (3) years excellentoral and written skills.
- Three (3) years knowledgeableand able to use standard computer
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