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Experience:
No experience
Employment Type:
Intern/Co-op
Posted:
4/28/2015
Job Category:
Health Care Provider
Industry:
Health Care & Medicine
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Inpatient Care Manager
Kaiser Permanente | Hillsboro, Oregon
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Job Description

Inpatient Care Mrg's are Registered Nurses who independently assure patients are admitted to the correct level of care for accurate billing & reimbursement, provide quality, cost effective clinical coordination/care management in the acute care & emergency care settings, manage patients w/routine & complex discharge planning needs by: independently assessing needs, developing & implementing plans of care for transitions across care settings. Inpatient Care Mrg's also serve as expert resource consultants & educators for physicians & other health care team members in discharge transition of care, coordination of internal & community resources, & support the evaluation & improvement of systems of care to support the optimal utilization of health care resources, while maintaining quality of patient care. The Inpatient Care Mrg assumes primary accountability for anticipating, assessing, developing, implementing, documenting, advising, & communicating a safe discharge plan of care for patients w/complex care needs.
 
Essential Functions:
Ensures review of all KP patients admitted to service area hospitals for appropriateness of admission; admission to the appropriate level of care status; length of stay consistent w/medical &/or surgical criteria; &, ensures authorization for hospitalization is received from non-Kaiser payer sources. Provides timely & accurate notification to Patient Billing Services verifying correct admit status. Facilitates care & services for non-Kaiser patients in the hospital setting approved by their payer source. Identifies potential delays in inpatient care or services that may result in length of stay extensions & communicate findings so improvement opportunities can be addressed by involved departments. Facilitates entries in patient charts that reflect & support definitive diagnoses & coding.
Ensures coordination of care toward timely discharge for routine & complex medical/surgical patients in hospital setting; by: Independently & proactively completing assessments which are thorough, timely, age appropriate, & reflect psychosocial support systems, care needs, benefit array, level of care determinations, & document same for designated population of patients. Developing safe discharge plans by working w/patients, families, & health care teams to develop a mutually agreeable plan of care that creatively optimizes the use of all available & appropriate resources to support the unique & particular needs of each patient on a case by case basis. Utilize case/family conferences & consults to develop these care plans as needed. Implementing care plans by ordering, brokering, & advocating for the patient & family, while educating the patient, family, & health care team about options & alternatives. Completing all necessary documentation for referrals & handoffs between care settings to ensure a seamless transition to another level of care. Acting as Kaiser Permanente "ambassador" to provide member information to care facilities (SNF, ICF, assisted living, adult foster homes, residential care facilities) & problem-solve/facilitate any issues which present barriers to safe transfers & the provision of quality care, such as: special equipment needs, symptom/behavior management, financial assessment & plan, clinical instability & complex care needs (IV therapy, enteral feedings, wound care, therapy needs).
This job description is not all encompassing.
Inpatient Care Mrg's are Registered Nurses who independently assure patients are admitted to the correct level of care for accurate billing & reimbursement, provide quality, cost effective clinical coordination/care management in the acute care & emergency care settings, manage patients w/routine & complex discharge planning needs by: independently assessing needs, developing & implementing plans of care for transitions across care settings. Inpatient Care Mrg's also serve as expert resource consultants & educators for physicians & other health care team members in discharge transition of care, coordination of internal & community resources, & support the evaluation & improvement of systems of care to support the optimal utilization of health care resources, while maintaining quality of patient care. The Inpatient Care Mrg assumes primary accountability for anticipating, assessing, developing, implementing, documenting, advising, & communicating a safe discharge plan of care for patients w/complex care needs.
 
Essential Functions:
Ensures review of all KP patients admitted to service area hospitals for appropriateness of admission; admission to the appropriate level of care status; length of stay consistent w/medical &/or surgical criteria; &, ensures authorization for hospitalization is received from non-Kaiser payer sources. Provides timely & accurate notification to Patient Billing Services verifying correct admit status. Facilitates care & services for non-Kaiser patients in the hospital setting approved by their payer source. Identifies potential delays in inpatient care or services that may result in length of stay extensions & communicate findings so improvement opportunities can be addressed by involved departments. Facilitates entries in patient charts that reflect & support definitive diagnoses & coding.
Ensures coordination of care toward timely discharge for routine & complex medical/surgical patients in hospital setting; by: Independently & proactively completing assessments which are thorough, timely, age appropriate, & reflect psychosocial support systems, care needs, benefit array, level of care determinations, & document same for designated population of patients. Developing safe discharge plans by working w/patients, families, & health care teams to develop a mutually agreeable plan of care that creatively optimizes the use of all available & appropriate resources to support the unique & particular needs of each patient on a case by case basis. Utilize case/family conferences & consults to develop these care plans as needed. Implementing care plans by ordering, brokering, & advocating for the patient & family, while educating the patient, family, & health care team about options & alternatives. Completing all necessary documentation for referrals & handoffs between care settings to ensure a seamless transition to another level of care. Acting as Kaiser Permanente "ambassador" to provide member information to care facilities (SNF, ICF, assisted living, adult foster homes, residential care facilities) & problem-solve/facilitate any issues which present barriers to safe transfers & the provision of quality care, such as: special equipment needs, symptom/behavior management, financial assessment & plan, clinical instability & complex care needs (IV therapy, enteral feedings, wound care, therapy needs).
This job description is not all encompassing.

Qualifications

Basic Qualifications:
Experience
Minimum two (2) years of acute hospital experience with progressive levels of responsibility.
Education
BSN or bachelor's degree in a health-care related field OR four (4) years of experience in hospital case management.
High School Diploma or General Education Development (GED) required.
License, Certification, Registration
Current Oregon and Washington RN license required. License in state where assigned required upon hire/transfer, application for license in secondary state required within 6 weeks of hire/transfer and must be obtained within 6 months.
Basic Life Support (BLS) for Health Care Providers required upon hire/transfer.
 
Additional Requirements:
Demonstrated ability to interrelate with physicians, nurses, support staff, and patients in interdisciplinary approach.
Demonstrated ability to work as part of a team and work as a constant patient advocate.
Basic physical, psychosocial, functional assessment skills.
Familiar with care processes and systems in settings internal and external to Kaiser Permanente.
Familiar with and able to collaborate with Kaiser Permanente and community resources.
Thorough knowledge of principles of teaching and delegation, physical assessment and care planning and appropriate utilization of acute hospital, long-term care and home care resources.
Able to document concise yet thorough clinical documentation of patient assessment and care needs.
Highly effective problem solving, written and verbal communication, organizational and time management skills.
Familiarity with and ability to use computers.
 

Preferred Qualifications:
Minimum two (2) years of Medical/Surgical or Critical Care Nursing.
Minimum three (3) years of recent experience in one or more of the following areas: Hospital Inpatient Discharge Planning, Community Health, Home Health and/or Utilization Management.
Recent experience in Home Health Agency or role responsibility for inpatient discharge planning.
Current Certification as a Certified Case Manager (CCM) or Accredited Case Manager (ACM).
Demonstrated ability to interrelate with physicians, nurses and patients.
Demonstrates customer-focused service skills.
Good clinical judgment to assess the needs of patients as they relate to next level of care.
Knowledge of the principles of patient teaching, disease prevention measures, physical assessment and appropriate utilization of acute hospital resources.
Knowledge of Medicare and Medicaid regulations related to eligibility requirements: hospital, nursing facilities, home health and hospice eligibility requirements.
Knowledge of Kaiser Permanente resources.
Able to type 30 WPM with accuracy.

Basic Qualifications:
Experience
Minimum two (2) years of acute hospital experience with progressive levels of responsibility.
Education
BSN or bachelor's degree in a health-care related field OR four (4) years of experience in hospital case management.
High School Diploma or General Education Development (GED) required.
License, Certification, Registration
Current Oregon and Washington RN license required. License in state where assigned required upon hire/transfer, application for license in secondary state required within 6 weeks of hire/transfer and must be obtained within 6 months.
Basic Life Support (BLS) for Health Care Providers required upon hire/transfer.
 
Additional Requirements:
Demonstrated ability to interrelate with physicians, nurses, support staff, and patients in interdisciplinary approach.
Demonstrated ability to work as part of a team and work as a constant patient advocate.
Basic physical, psychosocial, functional assessment skills.
Familiar with care processes and systems in settings internal and external to Kaiser Permanente.
Familiar with and able to collaborate with Kaiser Permanente and community resources.
Thorough knowledge of principles of teaching and delegation, physical assessment and care planning and appropriate utilization of acute hospital, long-term care and home care resources.
Able to document concise yet thorough clinical documentation of patient assessment and care needs.
Highly effective problem solving, written and verbal communication, organizational and time management skills.
Familiarity with and ability to use computers.
 

Preferred Qualifications:
Minimum two (2) years of Medical/Surgical or Critical Care Nursing.
Minimum three (3) years of recent experience in one or more of the following areas: Hospital Inpatient Discharge Planning, Community Health, Home Health and/or Utilization Management.
Recent experience in Home Health Agency or role responsibility for inpatient discharge planning.
Current Certification as a Certified Case Manager (CCM) or Accredited Case Manager (ACM).
Demonstrated ability to interrelate with physicians, nurses and patients.
Demonstrates customer-focused service skills.
Good clinical judgment to assess the needs of patients as they relate to next level of care.
Knowledge of the principles of patient teaching, disease prevention measures, physical assessment and appropriate utilization of acute hospital resources.
Knowledge of Medicare and Medicaid regulations related to eligibility requirements: hospital, nursing facilities, home health and hospice eligibility requirements.
Knowledge of Kaiser Permanente resources.
Able to type 30 WPM with accuracy.

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.