Experience Inc. Jobs

Description

We are seeking for a detail-oriented Intensive Case Management (ICM) Behavioral Coordinator dedicated to improving patient outcomes through effective case management and behavioral health support.

Under the supervision of the Utilization Management Operations Manager and the RN Assistant Director, the ICM Behavioral Coordinator plays a vital role in supporting RN Case Managers, Licensed Clinical Social Workers, and Medical Social Workers in delivering comprehensive case management and service coordination. This position focuses on managing cases of moderate to low acuity to mitigate unmet social needs and ancillary support services to prevent hospital re-admission.

Key responsibilities include:

• Assist patients who lack behavioral health providers and experience multiple readmissions due to unmanaged behavioral and social issues

• Facilitate authorizations and coordinate with behavioral health providers to secure appropriate care

• Process urgent, routine, pre-service, and retro authorization requests following the referral and authorization procedures established by the medical group

• Ensure timely processing of authorization referrals and coordinate care across inpatient, skilled nursing, and outpatient ancillary services to support safe discharge planning

• Prepare and process referrals

• Maintain and generate reports and monitor logs related to patient care coordination and case management

• Build trust and establish rapport with patients who are not actively engaged in behavioral therapy

• Conduct health screenings to identify risk factors, care gaps, and barriers, escalating concerns to RN Case Managers, the RN Assistant Director, and the Medical Director as needed

• Collaborate with RN Case Managers and Social Workers to develop non-clinical care plans

• Review pending claims for approval or denial decisions

Note: Position may convert to Career.

Salary Range: $34.37 - $47.31 Hourly

Qualifications

• Minimum of 2 years' experience working in a Managed Care Case Management and care coordination environment preferred

• High school diploma, GED or equivalent experience, Preferably has a background or degree in Psychology

• Experience processing Inpatient and ambulatory setting Managed Care referrals and case management

• Vodavi phone system experience preferred

• Ability to operate a wide variety of office equipment, including computers, printers, copy machines, facsimile receiver/transmitter, scanners and mailing equipment

• Proficient computer skills including working knowledge of Microsoft Excel and Word

• Ability to multi-task, work with frequent interruptions and meet deadlines

• Must be detailed oriented, attentive, organized, and able to follow directions

• Ability to communicate thoughts and information clearly and succinctly in writing as well as verbally

• Ability to lift up to 25 pounds

UCLA Health welcomes all individuals, without regard to race, sex, sexual orientation, gender identity, religion, national origin or disabilities, and we proudly look to each person’s unique achievements and experiences to further set us apart.