The ICM Social Work Coordinator supports Intensive Case Management (ICM) Social Workers and Nurses by providing non-clinical care coordination, referral and authorization processing, and service navigation for patients with moderate to high psychosocial and behavioral health needs. This role focuses on timely access to services, safe discharge planning, and prevention of unnecessary emergency department visits and hospital readmissions, particularly for high-risk and Medicare Advantage populations.

Key Responsibilities

• Coordinate and process urgent, routine, pre-service, and retro authorization requests in compliance with UCLA Medical Group, CMS, and health plan guidelines
• Prepare and manage referrals, review pending claims, and support approval or denial determinations
• Provide non-clinical care coordination for ICM-enrolled and high-risk patients across inpatient, SNF, outpatient, and post-acute settings
• Monitor hospital and SNF admissions and discharges; conduct post-discharge outreach and screenings
• Coordinate transitions of care, including transportation, DME, home health, and post-acute services
• Collaborate closely with ICM nurses, social workers, providers, hospitals, SNFs, and external programs
• Maintain accurate documentation and tracking within the electronic medical record and referral systems
• Support quality improvement, data collection, and program operations as needed