Patient Care Coordinator Case Manager SH
Company: Kaiser
Location: Santa Clara
Posted on: April 17, 2024
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Job Description:
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 Master's 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
Current California RN licensure required.
BLS Certification.
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.
Bachelor's degree in nursing or a health care related field
preferred.
Master's degree in case management preferred.
PrimaryLocation : California,Santa Clara,Santa Clara Hospital
HoursPerWeek : 16
Shift : Day
Workdays : Week1: Sun, Sat Week 2: Sun, Sat
WorkingHoursStart : 08:00 AM
WorkingHoursEnd : 04:30 PM
Job Schedule : Short Hour
Job Type : Standard
Employee Status : Regular
Employee Group/Union Affiliation : A10-NNU-California Nurse's
Association
Job Level : Individual Contributor
Job Category : Nursing Licensed & Nurse Practitioners
Department : Santa Clara Homestead Hospital - UR-Discharge Planning
- 0201
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.--s-p-m1--
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Keywords: Kaiser, Cupertino , Patient Care Coordinator Case Manager SH, Executive , Santa Clara, California
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