Description
UCLA HEALTH
To apply for this position please CLICK HERE
Description
The ED and SNF ICM Coordinator supports Medicare Advantage patients with frequent emergency department and skilled nursing facility utilization who are not assigned to a case manager. Under the direction of the RN Assistant Director, this role provides non-clinical care coordination, referral and authorization processing, and service navigation for high- to moderate-acuity patients. The position focuses on ED diversion, safe discharge planning, timely access to services, and prevention of avoidable hospital readmissions while ensuring compliance with CMS and UCLA Medical Group guidelines.
Key Responsibilities
- Coordinate and process urgent, routine, pre-service, and retro authorization requests in accordance with UCLA Medical Group, CMS, DOFR, and health plan requirements
- Track daily ED activity and support ED diversion and readmission prevention efforts
- Provide non-clinical care coordination for identified high-risk and ICM-enrolled patients across ED, inpatient, SNF, and post-acute settings
- Monitor hospital and SNF admissions and discharges; conduct post-discharge outreach and escalate high-risk concerns as needed
- Coordinate transitions of care, including hospital-to-SNF and SNF-to-home services such as transportation, DME, home health, and post-acute care
- Collaborate closely with concurrent review nurses, ICM nurses, social workers, hospitals, SNFs, PCPs, and external programs
- Maintain accurate documentation, tracking, and reporting within electronic medical records and referral systems
- Support quality improvement activities, data collection, appeals, and grievances as assigned
Salary Range: $35.47 – $48.82/HourlyQualifications
Required:
- High school diploma, GED or equivalent
- Experience processing Inpatient and ambulatory Managed Care referrals
- Ability to multi-task, work with frequent interruptions, and meet deadlines. Must be detailed, oriented, attentive, organized, and able to follow directions
- Proficient computer skills including working knowledge of Microsoft Excel and Word
- Ability to communicate thoughts and information clearly and succinctly in writing as well as verbally
- Ability to operate a wide variety of office equipment, including computers, printers, copy machines, facsimile receiver/transmitter, scanners and mailing equipment
Preferred:
- Minimum of 2 years’ experience working in a Managed Care Case Management and care coordination environment