Case Manager - Utilization Management Role open at Prime Healthcare Services in Sherman Oaks, California, United States

Overview

At Sherman Oaks Hospital, our dedicated team of professionals are committed to our core values of quality, compassion, and community. As a member of the Prime Healthcare Foundation, Sherman Oaks Hospital is actively seeking new members to join its award-winning team!

Sherman Oaks Hospital is a 153-bed, not-for-profit, acute-care community hospital located in Sherman Oaks, California. Staffed with over 500 employees and an extraordinary team of physicians, the hospital is recognized for advanced technology and compassionate care and provides 24/7 emergency care in addition to a full range of specialized medical, surgical, and diagnostic services to improve and save lives. Sherman Oaks Hospital has been nationally recognized multiple times as a "100 Top Hospital" by Fortune/Merative, holds an "A" grade in patient safety from The Leapfrog Group, Patient Safety Excellence recognition from Healthgrades, and more. For more information, visit www.shermanoakshospital.org.

We are an Equal Opportunity Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation, or other protected characteristics. If you need special accommodation for the application process, please contact Human Resources. Know Your Rights: https://www.eeoc.gov/sites/default/files/2022-10/EEOC_KnowYourRights_screen_reader_10_20.pdf

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.

Qualifications

Education and Work Experience

Required qualifications:

BSW or other Bachelor degree in a related field. At least one year experience in case management, discharge planning or nursing management;

CCM or obtained within 6 months of hire.

Experience and knowledge in basic to intermediate computer skills.

Behavioral Violence Prevention Training within 3 months of hire and maintain current.

Preferred qualifications:

Minimum 5 years of acute care experience preferred.

At least one-year experience in case management, discharge planning or management, preferred.

Current BCLS (AHA) certificate preferred.

Knowledge of Milliman Criteria and InterQual Criteria preferred.

Sherman Oaks Hospital offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options. A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $29.28 to $43.32. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.

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