Align yourself with an organization that has a reputation for excellence Cedars Sinai was awarded the National Research Corporation’s Consumer Choice Award 19 years in a row for providing the highest-quality medical care in Los Angeles. We were also awarded the Advisory Board Company’s Workplace of the Year. This award recognizes hospitals and health systems nationwide that have outstanding levels of employee engagement. Join us, and discover why U.S. News & World Report has named us one of America’s Best Hospitals What You Will Do in This Role: The Utilization Review Case Manager validates the patient’s placement to be at the most appropriate level of care based on nationally accepted admission criteria. The UR Case Manager uses medical necessity screening tools, such as InterQual or MCG criteria, to complete initial and continued stay reviews in determining appropriate level of patient care, appropriateness of tests/procedures and an estimation of the patient’s expected length of stay. The UR Case Manager secures authorization for the patient’s clinical services through timely collaboration and communication with payers as required. The UR Case Manager follows the UR process as defined in the Utilization Review Plan in accordance with the CMS Conditions of Participation for Utilization Review. Education : Assoc. Degree/College Diploma Graduate of an accredited nursing program Bachelor’s Degree Nursing License/Certifications: CA RN State License Basic Life Support (BLS) Experience : 3 years In acute nursing 2 years Case Management Physical Demands: Lifting, Standing, Walking, Sitting, Reaching Typing Working Title: Utilization Review Case Mgr Pr Department: Utilization Management Business Entity: Corporate Services Job Category: ,Patient Services,Patient Services Job Specialty: Case Management Position Type: Per Diem Shift Length: 8 hour shift Shift Type: Day