Already a member? sign in
You worked hard to earn your degree.
Explore jobs based on your education.
Explore Now

Job Category:
Nursing
Industry:
Health Care & Medicine
Employment Type:
Full time
Experience:
1-3 years of experience
Compensation:
Competitive
Posted:
8/15/2012
Case Manager - RN( Job Number: 128470)
(This job is no longer available)
Kaiser Permanente | Martinez, CA
loading
loading
School
Major
Grad Date
 
 

Not sure what types of jobs you are interested in?


Explore Jobs
Based on Your Education

Job Description

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.  

Description
 

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.

 

Essential Functions:

• 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.

 

Qualifications

Basic Qualifications:

• 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.

Primary Location

: 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.

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.

jobs.kp.org

KAISER PERMANENTE

 

About Kaiser Permanente

Company Description

Serving approximately 8.7 million members in nine states and the District of Columbia, Kaiser Permanente is America's leading nonprofit integrated health plan.

Kaiser Permanente's mission is to provide high-quality, affordable health care services to improve the health of our members and the communities we serve.

Our Northern California Region provides integrated health care services to approximately 3.2 million members. Approximately 4,400 physicians of The Permanente Medical Group provide services at 20 medical centers and numerous medical offices.

Company History

Founded in 1945, Kaiser Permanente is the nation’s largest not-for-profit health plan, serving more than 8.6 million members, with headquarters in Oakland, Calif. It comprises:

  1.   • Kaiser Foundation Health Plan, Inc.

  • Kaiser Foundation Hospitals and their subsidiaries

  • The Permanente Medical Groups.

At Kaiser Permanente, physicians are responsible for medical decisions. The Permanente Medical Groups, which provide care for Kaiser Permanente members, continuously develop and refine medical practices to help ensure that care is delivered in the most efficient and effective manner possible.

Kaiser Permanente’s creation resulted from the challenge of providing Americans medical care during the Great Depression and World War II, when most people could not afford to go to a doctor. Among the innovations it has brought to U.S. health care are:

  • prepaid health plans, which spread the cost to make it more affordable

  • physician group practice to maximize their abilities to care for patients

  • a focus on preventing illness as much as on caring for the sick

  • an organized delivery system, putting as many services as possible under one roof

Mission & Values

As a health care organization in the 21st century, we have a mission--to provide quality care for our members and their families, and to contribute to the well-being of our communities.

Working Here

When you bring your career to Kaiser Permanente, the work you do directly affects the health of millions. From the business people who shape our policies, to the IT professionals enabling life-saving data, to the nurses and physicians on the front line of patient care, everyone here has a role to play in the care continuum. Knowing you have a place in that process and witnessing the outcome of the work you do is empowering. It gives you a cause to stand behind. And it makes you feel proud of the work you do every day. When people witness the impact of their contributions, they excel. Together we have the power to make a difference.

Hiring Information

The first step in beginning your career search is to look for open jobs that match your skills, qualifications, and interests. Each posting includes a description of the position and the minimum required qualifications. Once you find a position you are interested in, register for an account and provide your information for consideration online.

Benefits

As an employee, you are eligible for benefits according to your full-time/part-time status and the number of hours scheduled to work per week. Benefits may vary based on your Kaiser Permanente region, position, scheduled hours, and representation by collective bargaining or employee groups, but generally include:

  • generous vacation, holiday, and sick leave

  • medical care (including prescriptions), vision, mental health, and dental care

  • disability and life insurance coverage

  • educational opportunities and tuition reimbursement

  • employee assistance programs

  • health care, dependent care, and transit spending account options

  • retirement plans

In addition, we believe in recognizing stellar performance and sponsor a variety of programs designed to reward our skilled, innovative, caring, and committed staff.

In short, at Kaiser Permanente, we understand that there is a direct correlation between happy employees and happy members. We take pride in the compassion and dedication of our employees and find many ways to reward their hard work. In return, our employees take pride in being a part of a collaborative, professional team focused on quality, service, and care.

Honors & Awards

Kaiser Permanente of Northern California has earned an "Excellent" rating from the National Committee for Quality Assurance (NCQA)-the nation's leading reviewer of health plan quality for consumers and employers. Excellent is the top rating granted by NCQA, which reviews satisfaction surveys, preventive measures, physician credentialing, member services and improvement initiatives.*

Both our Northern and Southern California regions were the only health plans in California identified by the NCQA in its list of the best health care programs in the Pacific States. (NCQA's The State of Health Care Quality 2003)

The Joint Commission on Accreditation of Healthcare Organizations accredits all Kaiser Foundation Hospitals in California.

For the seventh straight year, no other health plan has earned higher ratings from the California Cooperative Health Reporting Initiative on more measures than Kaiser Permanente. The annual ratings measure clinical quality and member satisfaction. (CCHRI Report on Quality 2003)

Our Northern California region received more three-star "Excellent" ratings than any other health plan surveyed by California's Office of the Patient Advocate on California's Quality of Care Report Card 2003-04.

* Commercial HMO and Medicare-contracted product lines: April 2003.