No matter what your job title, the work you do at Kaiser Permanente supports the health and well-being of our members. All 8.7 million of them. That’s because each of us—from our financial professionals and IT team members to our RNs and physicians on the front line of care—shares a commitment to providing the best possible care experience. With locations across the United States, we offer the opportunity to build a rewarding career in an environment that supports your success. Join us and put your beliefs into practice.
Please be aware that this position is currently under review as part of the jurisdictional process with the California Nurses Association to determine whether such position should be assigned to the CNA bargaining unit. This review is on a position-by-position basis and includes an analysis of the actual duties performed in each position under review. This determination will be made within the next several months. Should the determination be made that the position does belong to the CNA bargaining unit, you will be offered the opportunity to (a) follow the work into the CNA bargaining unit and become a member of the union, or (b) seek other employment within the organization. Should you have any questions regarding this notice, please contact your recruiter for further information
Coordinates w/ physicians, staff, & non-Kaiser providers & facilities regarding patient care. In conjunction w/ physicians, develops treatment plan, monitors all clinical activities, makes recommendations for alternative levels of care, identifies cost-effective protocols, & develops guidelines for care.
• Plans, develops, assesses, & evaluates care provided to members.
• In conjunction w/ physicians, evaluates & develops treatment plans, recommends alternative levels of care, & ensures compliance w/ federal, state, & local requirements.
• Develops & maintains case management policies & procedures.
• Coordinates, directs, & performs concurrent & retrospective reviews, & monitors level & quality of care.
• Coordinates the interdisciplinary approach to providing continuity of care, including utilization management, transfer coordination, discharge planning, & obtaining all authorizations/approvals as needed for outside services for patients/families.
• Consults w/ internal & external physicians, health care providers, discharge planning & outside agencies regarding continued care/treatment or hospitalization.
• Arranges & monitors follow-up appointments.
• Encourages member to follow prescribed course of care (e.g., drug therapy, physical therapy).
• Makes referrals to appropriate community services.
• Identifies & recommends opportunities for cost savings & improving the quality of care across the continuum.
• Develops & collects data, & trends utilization of health care resources.
• Interprets regulations, health plan benefits, policies, & procedures for members, physicians, medical office staff, contract providers, & outside agencies.
• Coordinates transmission of clinical & benefit treatment to patients, families & outside agencies.
• Acts as liaison for outside agencies, non-plan facilities, & outside providers.
• Coordinates repatriation of patients & monitors their quality of care.
• Previous case management experience preferred.
• Experience in utilization management, discharge planning, or transfer coordination.
• Bachelor's degree, or equivalent experience, in nursing or health related field.
• Masters degree preferred.
• Graduate of an accredited school of nursing.
• Current California RN license required.
• PHN preferred.
• Knowledge of Nurse Practice Act, The Joint Commission & other federal/state/local regulations.
: 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 128470. Principals only. Kaiser Permanente is an EEO/AA Employer.
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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.