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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/Hourly
Qualifications
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
At UCLA Health, you can help heal humankind, one patient at a time by improving health, alleviating suffering and delivering acts of kindness. As you do, you’ll achieve great things in your life and your career. We’re a world-class health organization with four hospitals consistently recognized among the nation’s very best as well as an internationally-renowned medical school, primary and specialty care clinics and much more. Within our dynamic, innovative and growing organization, you’ll find exceptional opportunities to make the most of your abilities in a supportive, empowering and inclusive environment. If you embrace our values of Integrity, Compassion, Respect, Teamwork, Excellence and Discovery we invite you to see all you can accomplish at UCLA Health.
