This position is primarily responsible for monitoring LCHC's inpatient activity and ensuring that a reasonable and efficient plan of care is being followed for each admission. This position will also assist providers in the area of Member Services and Utilization Management.
Principal Duties and Responsibilities
Responsible for identifying patient admissions, reviewing the plan of care, suggesting an alternative plan of
care as directed by LCHC providers, and arranging for services following discharge.
Assists providers in getting their patients access to care from outside vendors.
Works with the Department Director and Supervisor to develop and revise the utilization review process in order to
achieve LCHC objectives.
Responsible for all authorization of hospitalizations for HMO Members, including staff PBA members.
Responsible for coordinating care after hospitalization for HMO Members, including staff PBA members.
Responsible for orienting and educating new managed care members at LCHC.
Responsible for providing assistance as necessary to support the Department in achieving its daily duties, including
supporting the referral process, handling patient inquiries, and other duties as they arise.
Attends routine meetings with the Department's staff to review workflow and processes.
Participates in activities designed to effectively improve the quality of Department services.
Responsible for performing other duties as needed to assist LCHC in achieving its mission.
Required Skills and Abilities
Organizational skills acquired through experience and through academic training.
Ability and willingness to work in a multi-cultural environment.
Pro-active in thought and action.
An understanding of Managed Care activities and software tools.
Ability to strongly embrace and personify the mission of LCHC.
Required Knowledge, Experience, or Licensure/Registration
High School Diploma and (1) or more years of health care business office related duties. A college degree in related field or RN background is preferred
Lawndale Christian Health Center (LCHC) is a community-based nonprofit organization, founded in 1984 and dedicated to improving the health...