Case Manager RN
Company: Kaiser
Location: San Rafael
Posted on: September 15, 2023
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Job Description:
Please be aware that this position is currently under review as
part of the jurisdictional process with the California Nurses
Association to determine whether such position should be assigned
to the CNA bargaining unit. This review is on a
position-by-position basis and includes an analysis of the actual
duties performed in each position under review. This determination
will be made within the next several months. Should the
determination be made that the position does belong to the CNA
bargaining unit, you will be offered the opportunity to (a) follow
the work into the CNA bargaining unit and become a member of the
union, or (b) seek other employment within the organization. Should
you have any questions regarding this notice, please contact your
recruiter for further information. Coordinates with physicians,
staff, and non-Kaiser providers and facilities regarding patient
care. In conjunction with physicians, develops treatment plan,
monitors all clinical activities, makes recommendations for
alternative levels of care, identifies cost-effective protocols,
and develops guidelines for care.
Essential Functions:
- Plans, develops, assesses, and evaluates care provided to
members. Develops and maintains case management policies and
procedures. Coordinates, directs, and performs concurrent and
retrospective reviews, 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 as needed for outside services for
patients/families.
- Consults with internal and external physicians, health care
providers, discharge planning and outside agencies regarding
continued care/treatment or hospitalization.
- Coordinates repatriation of patients and monitors their quality
of care.
- Arranges and monitors follow-up appointments. Encourages member
to follow prescribed course of care (e.g., drug therapy, physical
therapy). Makes referrals to appropriate community services.
- Identifies and recommends opportunities for cost savings and
improving the quality of care across the continuum.
- Develops and collects data, and trends utilization of health care
resources.
- Interprets regulations, health plan benefits, policies, and
procedures for members, physicians, medical office staff, contract
providers, and outside agencies.
- Coordinates transmission of clinical and benefit treatment to
patients, families and outside agencies.
- Acts as liaison for outside agencies, non-plan facilities, and
outside providers. In conjunction with physicians, evaluates and
develops treatment plans, recommends alternative levels of care,
and ensures compliance with federal, state, and local
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
- N/A
Education
- Graduate of an accredited school of nursing.
- Bachelor's degree in nursing or health related field, OR four (4)
years of experience in a directly related field.
- High School Diploma or General Education Development (GED)
required.
License, Certification, Registration
- Current California RN license required.
Additional Requirements:
- Knowledge of Nurse Practice Act, The Joint Commission and other
federal/state/local regulations.
- Must be able to work in a Labor/Management Partnership
environment.
Preferred Qualifications:
- Minimum six (6) months of previous case management experience
preferred.
- Experience in utilization management, discharge planning, or
transfer coordination.
- Master's degree preferred.
- PHN preferred.
PrimaryLocation : California,San Rafael,San Rafael Hospital
HoursPerWeek : 1
Shift : Day
Workdays : Mon, Tue, Wed, Thu, Fri, Sat, Sun
WorkingHoursStart : 08:00 AM
WorkingHoursEnd : 04:00 PM
Job Schedule : Per Diem
Job Type : Standard
Employee Status : Regular
Employee Group/Union Affiliation : NUE-NCAL-09 NUE Non Union
Employee
Job Level : Individual Contributor
Job Category : Nursing Licensed & Nurse Practitioners
Department : San Rafael Hospital - Community Care Program -
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.
Keywords: Kaiser, San Rafael , Case Manager RN, Executive , San Rafael, California
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