Patient Care Coordinator Case Manager On-Call Day
Posted on: November 25, 2022
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.
- 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
- Monitors the progression of the discharge plan and facilitates
discussions with the multidisciplinary teams.
- Educates other healthcare team members on utilization and care
- Collaborates with and provides information to patients,
families, physicians, and staff regarding the discharge plans and
- 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
- 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
- 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,
- Current California RN licensure required.
- BLS Certification.
- 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
- Fundamental word processing & computer navigation skills & the
ability to interpret & use analytic data in day to day
- Knowledge of health care benefits associated with various
business line (Medicare/KPSA, Commercial/KFH, Medi-Cal, Federal,
- Must be able to work in a Labor/Management Partnership
- 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
- Master's degree in case management preferred.Job Schedule: Job
Category: Nursing Licensed & Nurse Practitioners
Keywords: Kaiser, Fremont , Patient Care Coordinator Case Manager On-Call Day, Executive , Fremont, California
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