Patient Care Coordination Case Manager Short Hour - On call - Day
Company: Recruitics JB
Location: Santa Clara
Posted on: September 20, 2024
Job Description:
Job Summary: Coordinates with physicians, staff and non-Kaiser
providers and facilities regarding patients transitions and
discharge planning. In conjunction with physicians, develops plans
of care and discharge plans, and makes recommendations for
alternative levels of care as required.Essential
Responsibilities:
- Utilization Management: Performs daily pre-admission,
admission, and concurrent utilization reviews using guidelines,
institutional policies/procedures, and other information to
determine appropriate levels of care and readiness for
discharge.
- Monitors the progression of the discharge plan and facilitates
discussions with the multidisciplinary teams.
- Educates other healthcare team members on utilization and care
coordination.
- Collaborates with and provides information to patients,
families, physicians, and staff regarding the discharge plans and
transitions.
- Understands and consistently applies the interpretation, and
utilization of member health care benefits.
- Conducts UM, care coordination and discharge planning
activities according to all applicable regulatory
requirements.
- Discharge Planning: Ensures continuity of care through
communication in rounds and written documentation, level of care
recommendations, transfer coordination, discharge planning and
obtaining authorizations/approvals as needed for outside services
for the patient.
- Develops, evaluates, and coordinates a comprehensive discharge
plan in conjunction with the patient/family, physician, nursing,
social services, and other health care providers and agencies.
- Regulatory: Conducts UM, care coordination, and discharge
planning activities according to all applicable regulatory
requirements.
- Kaiser Permanente conducts compensation reviews of positions on
a routine basis. At any time, Kaiser Permanente reserves the right
to reevaluate and change job descriptions, or to change such
positions from salaried to hourly pay status. Such changes are
generally implemented only after notice is given to affected
employees. Basic Qualifications: Experience
- Minimum four (4) years of experience in hospital patient care
delivery, OR completion of Masters degree in case management
program in lieu of minimum years of experience. Education
- Graduate of accredited school of nursing.
- Diploma/Associate Degree Nursing. License, Certification,
Registration
- Registered Nurse License (California)
- Basic Life Support Additional Requirements:
- Knowledge of the Nurse Practice Act, TJC, DMHC, CMS, NCQA,
HIPPA, ERISA, EMTALA & all other applicable federal/state/local
laws & regulations.
- Demonstrated strong communication and customer service skills,
problem-solving, critical thinking, & clinical judgment
abilities.
- Fundamental word processing & computer navigation skills & the
ability to interpret & use analytic data in day to day
operations.
- Knowledge of health care benefits associated with various
business line (Medicare/KPSA, Commercial/KFH, Medi-Cal, Federal,
etc.).
- Must be able to work in a Labor/Management Partnership
environment. Preferred Qualifications:
- Minimum two (2) years of experience in utilization review, case
management, and discharge planning preferred.
- Bachelors degree in nursing or a health care related field
preferred.
- Masters degree in case management preferred.
Keywords: Recruitics JB, Santa Clara , Patient Care Coordination Case Manager Short Hour - On call - Day, Executive , Santa Clara, California
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