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Experience:
1-3 years of experience
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Employment Type:
Intern/Co-op
Posted:
4/20/2015
Job Category:
Nursing
Industry:
Health Care & Medicine
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COORD, SKILLED NURSING CARE
Kaiser Permanente | Portland, Oregon
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Job Description

To optimize the efficiency, effectiveness & quality of clinical care provided by KP clinicians & facility staff through the use of utilization, case/care mgmt & customer service skills & techniques. To optimize patient/family satisfaction w/ care received in the SNF setting. To assure efficient & effective transitions of care to & from the SNF setting.

Essential Functions:
Enhances the delivery of case/care mgmt on a daily basis
Assists the KP team to enhance SNF quality at our contracted facilities
Partners w/ the facility & Sr Metrix program mgr to analyze quality outcome data using statistically valid methodologies & graphics
Negotiates performance improvement activities w/ facility
Consults w/ facility mgmt in setting annual quality improvement goals
Addresses high risk, high volume patient care activities
Identifies, tracks, & trends adverse events
Identifies & reports significant events
Partners w/ facility mgrs in developing systems to improve clinical quality & patient safety
Identifies significant knowledge deficits w/in care team & addresses them
Monitors, reports & interprets compliance survey results
Facilitates understanding & improvement of Nursing Home Compare related scores related to short term patients
Interprets Nursing Home Compare scores for Continuing Care Services quality board reports
Identifies & evaluates opportunities for improvement in patient hand-offs between settings
Identifies opportunities to reduce hospital readmissions both while the patient is in the SNF & post SNF discharge
Works w/ quality & utilization personnel in these settings & programs to improve performance
Supports KP clinicians in organizing & efficiently providing patient/family care through a variety of means
Facilitates patient care conferences
Assists interdisciplinary care team w/ the identification & development of care goals consistent w/ patient/family wishes, clinical prognosis & rehabilitation potential
Identifies barriers to achieving patient discharge & assists the care team in overcoming them on an individual patient & population basis
Assists the care team in defining patient care goals that must be in order for the patient to successful transfer to a lower level of care
Identifies & addresses unmet patient resource needs to achieve desired clinical outcomes, patient safety & efficient care both in the facility & in post discharge lower level of care
Coordinates activities of KP clinical resources
Provides patient case mgmt related to KP resources
Facilitates patient/family, facility & clinician care conferences to align goals, explore options & plan effective & efficient care transitions
Interprets utilization criteria for patients both prior to & during a SNF admission using accessible clinical info
Provides consultation to clinicians regarding last covered day
Educates patient & family regarding utilization criteria & appeal rights
Facilitates completion of inter-rater reliability exercises
Assures consistent application of utilization criteria in compliance w/ regulations
Provides utilization oversight of patients at non-contract & out of area facilities
Enhances customer service
Serves as a resource for complaint research & resolution & documents in complaint tracking system
Assesses patient & family care wishes related to end of life care
Assures patients at end of life have access to hospice, palliative care & POLSTs
This job description is not all encompassing
To optimize the efficiency, effectiveness & quality of clinical care provided by KP clinicians & facility staff through the use of utilization, case/care mgmt & customer service skills & techniques. To optimize patient/family satisfaction w/ care received in the SNF setting. To assure efficient & effective transitions of care to & from the SNF setting.

Essential Functions:
Enhances the delivery of case/care mgmt on a daily basis
Assists the KP team to enhance SNF quality at our contracted facilities
Partners w/ the facility & Sr Metrix program mgr to analyze quality outcome data using statistically valid methodologies & graphics
Negotiates performance improvement activities w/ facility
Consults w/ facility mgmt in setting annual quality improvement goals
Addresses high risk, high volume patient care activities
Identifies, tracks, & trends adverse events
Identifies & reports significant events
Partners w/ facility mgrs in developing systems to improve clinical quality & patient safety
Identifies significant knowledge deficits w/in care team & addresses them
Monitors, reports & interprets compliance survey results
Facilitates understanding & improvement of Nursing Home Compare related scores related to short term patients
Interprets Nursing Home Compare scores for Continuing Care Services quality board reports
Identifies & evaluates opportunities for improvement in patient hand-offs between settings
Identifies opportunities to reduce hospital readmissions both while the patient is in the SNF & post SNF discharge
Works w/ quality & utilization personnel in these settings & programs to improve performance
Supports KP clinicians in organizing & efficiently providing patient/family care through a variety of means
Facilitates patient care conferences
Assists interdisciplinary care team w/ the identification & development of care goals consistent w/ patient/family wishes, clinical prognosis & rehabilitation potential
Identifies barriers to achieving patient discharge & assists the care team in overcoming them on an individual patient & population basis
Assists the care team in defining patient care goals that must be in order for the patient to successful transfer to a lower level of care
Identifies & addresses unmet patient resource needs to achieve desired clinical outcomes, patient safety & efficient care both in the facility & in post discharge lower level of care
Coordinates activities of KP clinical resources
Provides patient case mgmt related to KP resources
Facilitates patient/family, facility & clinician care conferences to align goals, explore options & plan effective & efficient care transitions
Interprets utilization criteria for patients both prior to & during a SNF admission using accessible clinical info
Provides consultation to clinicians regarding last covered day
Educates patient & family regarding utilization criteria & appeal rights
Facilitates completion of inter-rater reliability exercises
Assures consistent application of utilization criteria in compliance w/ regulations
Provides utilization oversight of patients at non-contract & out of area facilities
Enhances customer service
Serves as a resource for complaint research & resolution & documents in complaint tracking system
Assesses patient & family care wishes related to end of life care
Assures patients at end of life have access to hospice, palliative care & POLSTs
This job description is not all encompassing

Qualifications

Basic Qualifications:
Two (2) years as a case manager
Two (2) years of adult medical surgical experience
Two (2) years of geriatric clinical practice in home health, hospice, hospital or long-term care setting
Bachelor's degree in nursing or equivalent knowledge and experience
RN license in Oregon upon hire
RN licensed in Washington within 2 months
Ability to use Microsoft Office software
Ability to efficiently utilize computerized medical record
Ability to take initiative in addressing quality and utilization issues without prompting
Ability to work with angry or hostile individuals in high pressure situations
Excellent  verbal and written communication and customer service skills
Ability to effectively work with a diverse population of patients, families, staff and providers
Ability to collect, analyze and report statistically meaningful quality and utilization data
Working knowledge of admission criteria for SNF, Home Health, Hospice and Hospital
 
Preferred Qualifications:
Two (2) years of previous utilization and quality management experience, preferred
Previous experience working in the long-term care setting, preferred
Bachelor's degree in nursing, preferred
CPHQ certification in Health Care Quality Improvement or CCM or Certification in geriatric nursing, preferred
Knowledge of Medicare SNF criteria, preferred
Basic Qualifications:
Two (2) years as a case manager
Two (2) years of adult medical surgical experience
Two (2) years of geriatric clinical practice in home health, hospice, hospital or long-term care setting
Bachelor's degree in nursing or equivalent knowledge and experience
RN license in Oregon upon hire
RN licensed in Washington within 2 months
Ability to use Microsoft Office software
Ability to efficiently utilize computerized medical record
Ability to take initiative in addressing quality and utilization issues without prompting
Ability to work with angry or hostile individuals in high pressure situations
Excellent  verbal and written communication and customer service skills
Ability to effectively work with a diverse population of patients, families, staff and providers
Ability to collect, analyze and report statistically meaningful quality and utilization data
Working knowledge of admission criteria for SNF, Home Health, Hospice and Hospital
 
Preferred Qualifications:
Two (2) years of previous utilization and quality management experience, preferred
Previous experience working in the long-term care setting, preferred
Bachelor's degree in nursing, preferred
CPHQ certification in Health Care Quality Improvement or CCM or Certification in geriatric nursing, preferred
Knowledge of Medicare SNF criteria, preferred

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.