ICM Coordinator - ED and SNF

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.

• 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 elevate 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