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Experience:
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Employment Type:
Intern/Co-op
Posted:
10/22/2015
Job Category:
Health Care Provider
Industry:
Health Care & Medicine
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Regional Referral Center RN Coordinator
Kaiser Permanente | Portland, Oregon
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Job Description

To assist NWP clinicians, KPNW members and community clinicians in the coordination of medical services between Kaiser Permanente and community providers and facilities. Includes interfacing with NWP clinicians, community providers and members to ensure the member receives high quality, safe, efficient and timely medical services.

Essential Functions:
Preview and preapprove requests for referral to community clinicians and/or programs for medically necessary services as requested by the NWP clinician.
Work directly with the member and the community clinician to coordinate medical services within KPNW, providing accurate and timely information to the community physician and member related to requested services.
Maintain knowledge base of resources available within the community and Kaiser Permanente assists with arranging for medical services in the appropriate location.
With Community Medicine Integration Center leadership, insures compliance with regulatory and accrediting requirements for utilization of referred services, including NCQA, MDQR, Federal and State agencies.
Maintains knowledge of Kaiser Permanente policies, procedures and benefits.
To assist NWP clinicians, KPNW members and community clinicians in the coordination of medical services between Kaiser Permanente and community providers and facilities. Includes interfacing with NWP clinicians, community providers and members to ensure the member receives high quality, safe, efficient and timely medical services.

Essential Functions:
Preview and preapprove requests for referral to community clinicians and/or programs for medically necessary services as requested by the NWP clinician.
Work directly with the member and the community clinician to coordinate medical services within KPNW, providing accurate and timely information to the community physician and member related to requested services.
Maintain knowledge base of resources available within the community and Kaiser Permanente assists with arranging for medical services in the appropriate location.
With Community Medicine Integration Center leadership, insures compliance with regulatory and accrediting requirements for utilization of referred services, including NCQA, MDQR, Federal and State agencies.
Maintains knowledge of Kaiser Permanente policies, procedures and benefits.

Qualifications

Basic Qualifications:
Experience
Minimum two (2) years as a Registered Nurse.
Education
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 2 weeks of hire/transfer and must be obtained within (six) 6 months.

Additional Requirements:
Demonstrated customer focused service skills.

Demonstrated ability to assimilate technical information.

Ability to maintain effectiveness in a busy health care environment.

Ability to work effectively with medial staff.
Ability to assess complex clinical management situations, synthesize data, develop and implement action plans.
Ability to handle highly confidential and other information with discretion.
Progressively responsible, broad based experience with health care management.
Demonstrated skills negotiating and communicating with physicians and other health care providers to assist with the coordination of services to appropriate sites and levels of care.
Working knowledge of computer systems and medical care delivery systems.

Preferred Qualifications:
Minimum two (2) years of work experience as a Registered Nurse within Kaiser Permanente preferred.
Experience in inpatient and outpatient settings within Kaiser Permanente preferred.
Bachelor's degree in nursing or related field preferred.
Working knowledge of electronic clinical information systems, including HealthConnect and Results Reporting preferred.
Working knowledge of regulatory and accreditation requirements related to health care and health maintenance organizations preferred.
Comprehensive knowledge of Northwest Permanente and Kaiser Health Plan policies, procedures, personnel, goals, objectives, data systems and organizational structure preferred.
Basic Qualifications:
Experience
Minimum two (2) years as a Registered Nurse.
Education
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 2 weeks of hire/transfer and must be obtained within (six) 6 months.

Additional Requirements:
Demonstrated customer focused service skills.

Demonstrated ability to assimilate technical information.

Ability to maintain effectiveness in a busy health care environment.

Ability to work effectively with medial staff.
Ability to assess complex clinical management situations, synthesize data, develop and implement action plans.
Ability to handle highly confidential and other information with discretion.
Progressively responsible, broad based experience with health care management.
Demonstrated skills negotiating and communicating with physicians and other health care providers to assist with the coordination of services to appropriate sites and levels of care.
Working knowledge of computer systems and medical care delivery systems.

Preferred Qualifications:
Minimum two (2) years of work experience as a Registered Nurse within Kaiser Permanente preferred.
Experience in inpatient and outpatient settings within Kaiser Permanente preferred.
Bachelor's degree in nursing or related field preferred.
Working knowledge of electronic clinical information systems, including HealthConnect and Results Reporting preferred.
Working knowledge of regulatory and accreditation requirements related to health care and health maintenance organizations preferred.
Comprehensive knowledge of Northwest Permanente and Kaiser Health Plan policies, procedures, personnel, goals, objectives, data systems and organizational structure 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.