Experience:
5+ years of experience
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Employment Type:
Part time
Posted:
12/22/2019
Job Category:
Nursing
Case Manager Specialist RN
(This job is no longer available)
Kaiser Permanente | Ontario, CA
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Job Description

Description:

Works collaboratively with an assigned panel of physicians to manage the patient's specialized needs. The managing team does differ according to the chronic disease. Duties include assessment to identify member needs and development of specific care management plan to address needs. In conjunction with the Physician, implements care/treatment plan by coordinating access to health services across multiple providers/ disciplines, monitors care, makes determination to arrange transportation and transfer patient if indicated, identifies cost-effective measures, makes recommendations for alternative levels of care and utilization of resources, promotes self-care management and ensures paper work is completed. Is an indirect caregiver. Complies with other duties as described. Must be able to work collaboratively with the Multidisciplinary team.

Essential Responsibilities:

Evaluates and identifies members' needs. Interfaces with Primary Care Physicians, Specialists and various disciplines on the development of case management plans/programs.

Monitors and evaluates the effectiveness of the case management plans and modifies as necessary.

Coordinates the interdisciplinary approach to providing continuity of care, including utilization management, transfer coordination, discharge planning and obtaining all authorizations/approvals/transfers as needed for outside services for patients/families.

Acts as a clinical liaison, per their specialty, with outside agencies such as County CCS, non-plan facilities, outside providers, employers and/or workers' compensation carriers and third party administrators.

Prepares reports, communicates program changes to appropriate staff and develops protocols in accordance with state regulations.

Acts as a patient advocate and educator to assure that the patient has the knowledge to care for his/her condition and patient is educated and empowered to be responsible for participating in the plan of care.

Develops individualized patient/family education plan focused on self-management, delivers patient/family education specific to a disease state.

Develops and updates training and educational materials and presents to appropriate staff, members and families. Facilitates patients' return to normal daily activities by teaching and making appropriate referrals for outside services/continued care.

Consults with internal and external physicians, health care providers, discharge planners, and outside agencies regarding continued care/treatment or hospitalization or referral to support services or placement.

May need to facilitate transportation and housing arrangements for patient. Coordinates transmission of clinical and benefit treatment to patients, families and outside agencies.

Participates in data collection and analysis of clinical outcomes of care and customer satisfaction standards. Participates in the formulation and implementation/monitoring of action strategies and outcomes of care or customer service. Ensures that accurate records are maintained of the care associated with each patient.

Interprets regulations, health plan benefits, policies, and procedures for members, physicians, medical office staff, and contract providers and outside agencies.

Basic Qualifications:

Experience

Minimum two (2) years of clinical experience as an RN in an acute care or ambulatory care setting required.

(2) years recent (within the past three (3) years) clinical experience in Maternal Child Health, FCC, Ob/Gyn or Women's Health in acute care or ambulatory care.

Demonstrated knowledge of maternal/fetal medicine, including high risk pregnancies.

Education

Bachelor's degree or equivalent experience four (4) years required.

License, Certification, Registration

Current California RN license required.BLS

Additional Requirements:

Demonstrated ability to utilize/apply the general and specialized principles, practices, techniques and methods of utilization review/management, care coordination, transfer coordination, discharge planning or case management.

Working knowledge of regulatory requirements and accreditation standards (TJC, Medicare, Medi-Cal, etc.).

Demonstrated ability to utilize written and verbal communication, interpersonal, critical thinking and problem-solving skills required.Computer literacy skills required.

Preferred Qualifications:

Bachelor's degree in nursing or healthcare related field preferred.

Case Management Certification or certification in the area of specialty preferred.Experience with diabetic case management required.

Notes:

* This is a temporary position for approximately 3 months.
* This case manager position will cover gestational and Type 1 Diabetes in pregnant population.

Primary Location: California,Ontario,Ontario - Vineyard Medical Offices - D 2295 South Scheduled Weekly Hours: 24 Shift: Day Workdays: Mon, Wed, Fri Working Hours Start: 8:30 AM Working Hours End: 5:00 PM Job Schedule: Part-time Job Type: Standard Employee Status: Temporary Employee Group/Union Affiliation: SCNSC Job Level: Individual Contributor Job Category: Nursing Licensed Department: OB GYN Travel: No Kaiser Permanente is an equal opportunity employer committed to a diverse and inclusive workforce. Applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), age, sexual orientation, national origin, marital status, parental status, ancestry, disability, gender identity, veteran status, genetic information, other distinguishing characteristics of diversity and inclusion, or any other protected status.

External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with federal and state laws, as well as applicable local ordinances, including but not limited to the San Francisco and Los Angeles Fair Chance Ordinances.

Click here for additional requirements >

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.