At Kaiser Permanente Northern California, you’ll join a team of health advocates who share your passion for helping people. From our financial professionals and IT team members to our RNs and physicians on the front line of care—we work together to help our members achieve their best level of wellness. And you’ll be inspired to do the same. Whether you dream of sailing the bay, hitting the slopes in the Sierras, hiking Yosemite, attending the opera, or strolling the vineyards, you’ll discover the cultural and recreational diversity that makes Northern California one of the most desirable places in the world to live and work. Northern California’s largest health plan, Kaiser Permanente provides you with the resources, scope, and opportunity you need to realize your goals. Come see for yourself.
Provides inpatient and intensive outpatient case management for high-risk, high-utilizing members with acute and/or
chronic psychiatric conditions across the continuum of care. Develops treatment and care plans for the
• Plans, develops, coordinates, assesses, and evaluates services provided to members to promote quality and cost effective outcomes. Develops and maintains case management policies and procedures to assure optimal and appropriate member utilization of services.
• Coordinates the interdisciplinary approach to providing continuity of care, including utilization management, transfer coordination, discharge planning, and obtaining all authorizations/approvals for outside services. Participates in the development of care paths.
• As an Intensive Case Manager coordinates the care of a large caseload of high risk patients and provides assessments and interventions in the community including in-home visits. Consults with internal and external physicians, health care providers, discharge planning and outside agencies regarding continued care/treatment or hospitalization.
• Arranges and monitors follow-up appointments. Makes referrals to appropriate community services.
• Identifies and recommends opportunities for cost savings and quality of care improvements across the continuum. Develops and collects reports and data, and trends utilization of health care resources.
• Develops and presents in-service training and communication to both internal and external stakeholders.
• Interprets regulations, health plan benefits, policies, and procedures for members, physicians, medical office staff, contract providers, and outside agencies.
• Coordinates the transmission of clinical and benefit information and treatment to patients, families and outside agencies including issuing Non-Coverage and Denial of Benefits letters consistent with Health Plan Regulations.
• Acts as liaison to psychiatry clinics outside agencies, non-plan facilities, and outside providers.
• Coordinates repatriation of patients and monitors their quality of care.
• Provides administrative case management oversight to Inpatient Psychiatric Facilities, Crisis Residential.
• Programs, and IMDs to ensure that services delivered to our members meet Kaiser's Quality and Utilization expectations and guidelines.
• Provides administrative on-call to the RSR/Subregional Office.
• Provides Clinical and Administrative documentation in accordance with Kaiser Regional Psychiatric Standards including the Inpatient/Integrated Urgent Services Guidelines.
• Travel is required.
• Previous experience (usually 2 years) in an inpatient psychiatric setting or psychiatric emergency service.
• Previous experience (usually 2 years) of care management or clinical experience, and responsibility for a large caseload (50-100) for an extended period of time.
• Master's (Social Work or Psychology), or PhD (Psychology) required. • LCSW, MFT or Psychologist License required.
• Must have a National Provider Identifier (NPI), or obtain an NPI, prior to employment start date.
• Demonstrated expertise in crisis management.
• Demonstrated experience in utilization data collection and cost benefit analysis.
• Knowledge of JCAHO, and other local, state, and federal regulations.
• Must be able to work in a Labor Partnership Environment.
California-Martinez-Martinez Hacienda Medical Offices 200 Muir Rd.
External hires must pass a background check/drug screen. We are proud to be an equal opportunity/affirmative action employer.
Please visit http://jobs.kp.org for complete qualifications and job submission details, referencing job number 128364. Principals only. Kaiser Permanente is an EEO/AA Employer.
If you would like to hear the Kaiser Permanente story as told by our employees, watch the videos at kp.org/jobs/video. Follow us on twitter.com/KPCareers or visit the KP Careers tab on facebook.com/KPThrive.
This position supports Kaiser Permanente’s code of conduct and compliance by adhering to all laws and regulations, accreditation and licensure requirements, and internal policies and procedures.