Continuing Care Utilization Review Coordinator RN
3 days ago
Conducts utilization review for in-house patients and/or those members at contracted facilities. Assists in the discharge planning process.
Essential Responsibilities:- Conducts utilization review for in-house patients and/or members who have been admitted to contracted facilities. Interviews patients/caregivers regarding care after hospitalization.
- Conducts clinical reviews based on established treatment criteria.
- Collaborates with physicians on clinical reviews, keeps them appraised of Kaiser clinical criteria.
- Reviews utilization patterns, identifies trends and problems areas for special studies.
- Assists in collecting and assimilating clinical data to enhance the quality of services.
- Generates quality improvement results.
- Reports and investigates unusual occurrences and questions inappropriate decisions based on their professional expertise.
- Assists other health care providers in the discharge planning process and triaging on alternative unit of care.
- Counsels on Medicare and health care plan coverage.
- Coordinates referrals to appropriate agencies/facilities.
- 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 two (2) years of experience in an inpatient setting OR if for Skilled Nursing departments, minimum two (2) years of experience in a skilled nursing facility.
Minimum one (1) year of utilization experience required.
Education
Bachelors degree in nursing or health related field required, OR four (4) years of experience in a directly related field.
Graduate of accredited school of nursing.
High School Diploma or General Education Development (GED) required.
License, Certification, Registration
Driver's License (California)
Registered Nurse License (California)
Basic Life Support
Additional Requirements:
Demonstrated knowledge of diagnostic codes.
Must be able to work in a Labor/Management Partnership environment.
Bilingual (Spanish) Level I required.
Preferred Qualifications:
Clinical expert in area of review preferred.
Masters degree preferred.
-
Santa Clara, United States Kaiser Permanente Full timeJob Summary:Conducts utilization review for in-house patients and/or those members at contracted facilities. Assists in the discharge planning process.Essential Responsibilities:Conducts utilization review for in-house patients and/or members who have been admitted to contracted facilities. Interviews patients/caregivers regarding care after...
-
Patient Care Coordinator Case Manager SH
2 months ago
Santa Clara, United States Kaiser Permanente Full timeCoordinates 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,...
-
Patient Care Coordinator Case Manager
2 months ago
Santa Clara, United States Kaiser Permanente Full timeJob 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...
-
Patient Care Coordinator Case Manager
2 months ago
Santa Clara, United States Disability Solutions Full timeJob 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...
-
RN Case Care Coordinator
3 weeks ago
Santa Cruz, United States Dignity Health Full timeOverview About Us Dominican Hospital (a member of Dignity Health) is a 222-bed facility that offers a wide range of services to residents of California's Central Coast. With 24/7 emergency care, comprehensive care in cardiac, orthopedics, oncology, women's and children's services, we continue to lead the region in medical innovation and excellence in...
-
Patient Care Coordinator
2 weeks ago
Santa Rosa, California, United States Diverse Lynx Full timeJob Title: Registered Nurse/Case ManagerJob Summary: We are seeking a skilled Registered Nurse/Case Manager to join our team at Diverse Lynx. In this role, you will be responsible for coordinating admissions, performing concurrent and retrospective utilization review, and facilitating discharge planning. Your expertise will help ensure that our patients...
-
RN Case Manager
1 month ago
Santa Ana, California, United States KPC Health Full timeCare Coordination ExpertiseKPC Health seeks a skilled RN Case Manager to collaborate with patients, families, and healthcare providers in coordinating patient care. This role requires strong advocacy, communication, and education skills to identify and coordinate appropriate services, resources, and facilities throughout the care continuum.Key...
-
Nurse Care Coordinator
4 days ago
Santa Clara, California, United States Kaiser Permanente Full timeJob Summary:A professional caregiver is sought for a group of patients in a designated time frame. The successful candidate will provide care to patients via the therapeutic use of self, the nursing process, the environment and instrumentation, and other health care team members.Key Responsibilities:• Performs ongoing systematic assessment/data collection...
-
MDS Coordinator
2 weeks ago
Santa Clara, United States Vi Living Full timeOverview: Vi is recognized as a Great Place to Work and one of Glassdoor's 100 Best Companies to work for. Learn from the best and accelerate your career with Vi.What We Offer: Competitive payExceptional benefitsAccess to earned wagesGenerous Paid Time Off - start accruing on day one401k with company matchPaid maternity and paternity benefitsAward-winning...
-
MDS Coordinator
2 weeks ago
Santa Clara, United States Vi Living Full timeOverview: Vi is recognized as a Great Place to Work and one of Glassdoor's 100 Best Companies to work for. Learn from the best and accelerate your career with Vi.What We Offer: Competitive payExceptional benefitsAccess to earned wagesGenerous Paid Time Off - start accruing on day one401k with company matchPaid maternity and paternity benefitsAward-winning...
-
MDS Coordinator
2 weeks ago
Santa Clara, United States Vi Living Full timeOverview: Vi is recognized as a Great Place to Work and one of Glassdoor's 100 Best Companies to work for. Learn from the best and accelerate your career with Vi.What We Offer: Competitive payExceptional benefitsAccess to earned wagesGenerous Paid Time Off - start accruing on day one401k with company matchPaid maternity and paternity benefitsAward-winning...
-
MDS Coordinator
2 weeks ago
Santa Clara, United States Vi Living Full timeOverview: Vi is recognized as a Great Place to Work and one of Glassdoor's 100 Best Companies to work for. Learn from the best and accelerate your career with Vi.What We Offer: Competitive payExceptional benefitsAccess to earned wagesGenerous Paid Time Off - start accruing on day one401k with company matchPaid maternity and paternity benefitsAward-winning...
-
MDS Coordinator
2 weeks ago
Santa Clara, United States Vi Living Full timeOverview: Vi is recognized as a Great Place to Work and one of Glassdoor's 100 Best Companies to work for. Learn from the best and accelerate your career with Vi.What We Offer: Competitive payExceptional benefitsAccess to earned wagesGenerous Paid Time Off - start accruing on day one401k with company matchPaid maternity and paternity benefitsAward-winning...
-
MDS Coordinator
2 weeks ago
Santa Clara, United States Vi Living Full timeOverview: Vi is recognized as a Great Place to Work and one of Glassdoor's 100 Best Companies to work for. Learn from the best and accelerate your career with Vi.What We Offer: Competitive payExceptional benefitsAccess to earned wagesGenerous Paid Time Off - start accruing on day one401k with company matchPaid maternity and paternity benefitsAward-winning...
-
MDS Coordinator
2 weeks ago
Santa Clara, United States Vi Living Full timeOverview: Vi is recognized as a Great Place to Work and one of Glassdoor's 100 Best Companies to work for. Learn from the best and accelerate your career with Vi.What We Offer: Competitive payExceptional benefitsAccess to earned wagesGenerous Paid Time Off - start accruing on day one401k with company matchPaid maternity and paternity benefitsAward-winning...
-
Full Time Registered Nurse
2 weeks ago
Santa Clara, United States Compunnel Full timeb>Job Summary:The Registered Nurse (RN) in the Pediatric Intensive Care Unit (PICU) is responsible for providing critical care to pediatric patients with complex and life-threatening conditions. The RN will work as part of an interdisciplinary team, delivering high-quality, compassionate care while monitoring and supporting patients' physical and emotional...
-
Patient Care Coordinator
2 weeks ago
Santa Clara, United States Serene Health Services Full timeEmpowering Wellness, Transforming LivesOptima Medical Management Group is dedicated to enhancing the quality of life by promoting wellness. At Optima MMG and all of its divisions: Serene Health, A Positive Choice, and PsycHealth, our mission is to provide comprehensive support and care that not only addresses immediate concerns but also fosters long-term...
-
Part-Time Overnight RN
2 months ago
Santa Clara, United States Maxim Healthcare Service Full time$38 - $40 / per hour Maxim Healthcare in Santa Clara is hiring for a Registered Nurse to work with Pediatric and/or Adult patients in their own homes. Why Join Maxim: Competitive Pay & Weekly Paychecks Health, Dental, Vision, HSA and Life Insurance Paid Time Off 401(k) Savings Plan Maxcares Awards Program Responsibilities: Utilizes the nursing...
-
Part-Time Overnight RN
4 weeks ago
Santa Clara, United States Maxim Healthcare Services Full time$37 - $40 / per hourMaxim Healthcare in Santa Clara is hiring for a Registered Nurse to work with Pediatric and/or Adult patients in their own homes.Why Join Maxim:Competitive Pay & Weekly PaychecksHealth, Dental, Vision, HSA and Life InsurancePaid Time Off401(k) Savings PlanMaxcares Awards ProgramResponsibilities:Utilizes the nursing process to plan,...
-
Development Review Engineer
3 months ago
Santa Rosa, United States Coastland | DCCM Full timeDevelopment Review EngineerAbout the Company: Coastland | DCCM has an immediate opening for a Development Review Engineer involves delivering engineering review services to public agency clients.About the Role: Development Review Engineer duties may include:Evaluating development entitlement applications, which include design review permits, conditional use...