Case Manager Continuing Care Coord RN-PD
Company: Kaiser
Location: San Diego
Posted on: May 2, 2024
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Job Description:
Coordinates with physicians, staff, and non-Kaiser
providers/facilities regarding patient care/ population based
management for patients in specifically defined geriatric or other
specifically defined patient populations in order to plan and
implement a comprehensive, multi-disciplinary approach to manage
health conditions, utilization of resources and protocols, patient
selfcare, implementation and evaluation of treatment plan across
the care continuum (primary, secondary, tertiary and continued
care). In conjunction with physicians, develops treatment plan,
monitors care, makes recommendations for alternative levels of
care, identifies cost-effective protocols and care paths and
develops guidelines for care that may require coordination across
systems of multiple providers/services. Complies with other duties
as described. Must be able to work collaboratively with the
Multidisciplinary team. Essential Functions: - Plans, develops,
assesses and evaluates care provided to members. - In conjunction
with primary care and specialist physicians, evaluates and develops
baseline medical and psychosocial evaluations and individualized
patient care/treatment plans. - Recommends alternative levels of
care and ensures compliance with federal, state, and local
requirements. - Develops individualized patient/family education
plan focused on self-management; delivers patient/family education
specific to a disease state. - Encourages member to follow
prescribed course of care (e.g., drug therapy, physical therapy). -
Coordinates care/services with utilization and/or quality reviewers
and monitors level and quality of care. - 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. - Makes
referrals to appropriate community services and outside providers.
- Coordinates transmission of clinical and benefit treatment to
patients, families and outside agencies. - Consults with internal
and external physicians, health care providers, discharge planning
and outside agencies regarding continued care/treatment,
hospitalization or referral to support services or placement. -
Arranges and monitors follow-up appointments. - Coordinates
repatriation of patients and monitors their quality of care. -
Develops and collects data; trends utilization of health care
resources. - Produces population based reports on outcomes specific
to defined patient populations. - Participates with healthcare
team/providers in actualizing outcomes by planning, evaluating and
implementing decisions and strategies to achieve predetermined
cost, clinical, quality, utilization and service outcomes. -
Develops and maintains case management policies and procedures. -
Identifies and recommends opportunities for cost savings and
improving the quality of care across the continuum. - Interprets
regulations, health plan benefits, policies,and procedures for
members, physicians, medical office staff, contract providers, and
outside agencies. - Acts as liaison for outside agencies, non-plan
facilities, and outside providers. - Participates in committees,
teams or other work projects/duties as assigned. Basic
Qualifications: Experience --- Minimum one (1) year clinical
experience as an RN in an acute care setting, plus two (2) years of
clinical experience as an RN in a licensed home health or hospice
agency required. --- For positions in Special Needs&Care
Programs (Care Plus/Guidance): two (2) years of clinical experience
as an RN in an acute care setting required. Education --- Please
refer to Minimum Work Experience and Qualifications Sections.
Licenses, Certifications, Registrations --- Current California RN
license required. --- AHA BLS. Additional Requirements: ---
Demonstrated ability to utilize/apply the general and specialized
principles, practices, techniques and methods of utilization
review/management, 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 preferred. Notes: --- 7 days a week
service. --- Day shift and location assignment can vary based on
operational needs. PrimaryLocation : California,San Diego,Mission
Road Administration Building A HoursPerWeek : 1 Shift : Day
Workdays : Mon, Tue, Wed, Thu, Fri, Sat, Sun WorkingHoursStart :
08:30 AM WorkingHoursEnd : 05:00 PM Job Schedule : Per Diem Job
Type : Standard Employee Status : Regular Employee Group/Union
Affiliation : B21-AFSCME-SCNSC Job Level : Individual Contributor
Job Category : Nursing Licensed & Nurse Practitioners Department :
San Diego Admin Offices 1 - Geriatric Medicine - 0806 Travel : Yes,
75 % of the Time 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.
Keywords: Kaiser, San Diego , Case Manager Continuing Care Coord RN-PD, Executive , San Diego, California
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