Patient Care Coordinator Case Manager

3 weeks ago


Fremont, United States Kaiser Permanente Full time

**Job 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 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 Masters 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
- Registered Nurse License (California)
- Basic Life Support

**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.
- Bachelors degree in nursing or a health care related field preferred.
- Masters degree in case management preferred.

PrimaryLocation : California,Fremont,Fremont Hospital

HoursPerWeek : 1

Shift : Night

Workdays : Mon, Tue, Wed, Thu, Fri, Sat, Sun

WorkingHoursStart : 11:00 PM

WorkingHoursEnd : 07:30 AM

Job Schedule : Call-in/On-Call

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 : Fremont Hospital - UR-Discharge Planning - 0201

Travel : No



  • Fremont, United States Kaiser Permanente Full time

    Job 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...


  • Fremont, United States All Care Dental Part time $20 - $30

    All Care Dental is looking for a Dental Front Office Patient Coordinator The responsibilities include preparing and issuing invoices and submitting insurance claims, for dental procedures. running credit card payments , posting payments , recare and hygiene schedules. Knowledge of centric ascend is a big plus and inputting patient data on computer is...


  • Fremont, United States Washington Hospital Full time

    DescriptionSalary Range: $30.04 - $40.56 Job SummaryUnder the supervision of the Director of Case Management & Chief of Quality Resource Management, the Case Management assistant will provide support to Case Managers and Social Workers, and the Quality Department. Will assist with coordinating movement through the continuity of care to ensure timely...


  • Fremont, United States Triza Home Health Care Full time

    The Director of Patient Care Services (DPCS) / DON position is a full-time benefited opportunity. This is an opportunity for someone with clinical supervisory experience to ramp up into a management role. **Essential Job Functions/Responsibilities**: - Coordinates and oversees all direct and indirect patient services provided by clinical organization...

  • Intake Coordinator

    4 weeks ago


    Fremont, United States Triza Home Health Care Full time

    Triza Home Health Care has a part-time and full-time employment opportunity available as an Intake Coordinator in our Fremont office. Office hours are Mon-Fri 8:30am - 5pm, on-call outside of those days and hours. **Description**: The role is responsible for the referral and patient intake process including data entry, establishing and maintaining positive...

  • Dental Front Office

    6 hours ago


    Fremont, United States Serene Dental Full time $25 - $40

    Dental Office Coordinator & Production Administrator  with a minimum 5 years experience in a leadership positionResponsibilities:Hands-on leadership opportunity for a person with excellent communication skills & dental front office experience to grow while having fun and working closely with the doctor and other staff to deliver office goals.All dental...

  • Dental Front Office

    3 weeks ago


    Fremont, United States Serene Dental Full time $25 - $40

    Dental Office Coordinator, Scheduler, and AdministratorResponsibilities:Great hands-on leadership opportunity for a person with excellent communication skills & dental front office experience to grow while having fun and working closely with the doctor and other staff to deliver office goals.All dental office front desk functions including scheduling,...

  • Registered Nurse

    1 week ago


    Fremont, United States American Hospice and Home Health Care Full time

    Job Type Full-time, Part-time, Contract Description Job Type Full-time, Part-time Job Pay: $60 - $70 an hour $110 - $200 Per Visit American Hospice and Home Health Services is currently seeking a full-time or part-time RN to service in Alameda County. Negotiable salary, hourly, and per-visit pay rates depending on experience.Job description: The Registered...

  • Dental Front Office

    4 days ago


    Fremont, United States Serene Dental Full time $25 - $40

    Dental Office Coordinator, Scheduler, and AdministratorResponsibilities:Great hands-on leadership opportunity for a person with excellent communication skills & dental front office experience to grow while having fun and working closely with the doctor and other staff to deliver office goals.All dental office front desk functions including scheduling,...


  • Fremont, United States Dental Associates Group Full time $24 - $26

    Join the Gentle Caring Dentistry team as a full-time Orthodontic Coordinator and be the friendly face that makes our patients feel welcome and supported!We are actively seeking an enthusiastic individual to fill this vital role in our practice, known for its commitment to exceptional patient care.If you thrive on providing outstanding customer service,...


  • Fremont, United States CompHealth Full time

    Posted 30+ days ago$107k - $126k/yr Your compensation offer will be calculated according to your experience, qualifications, and the complexity of the role. Shift length, call, and overtime may positively impact compensation. Please reach out to your consultant for more information.PermanentFremont, CaliforniaQuick Facts Inpatient and intensive outpatient...

  • Case Manager

    1 week ago


    Fremont, United States City of Fremont Full time

    The Human Services Department is recruiting for Case Manager (Family Resource Center). VIEW OUR RECRUITMENT BROCHURE The first review of applications is January 19, 2024. T he recruitment may close without notice after this date, so interested applicants are encouraged to apply immediately. A resume and supplemental questionnaire (part of the online...

  • Case Manager

    3 hours ago


    Fremont, United States City of Fremont Full time

    The Human Services Department is recruiting for Case Manager (Family Resource Center). VIEW OUR RECRUITMENT BROCHURE The first review of applications is January 19, 2024. T he recruitment may close without notice after this date, so interested applicants are encouraged to apply immediately. A resume and supplemental questionnaire (part of the online...


  • Fremont, United States Western & Southern Life Full time

    Overview: Processes and reviews underwriting requirements by conducting customer interviews to gather non-medical and medical information. Works with some supervision but is empowered to approve applications and other decisions within the limits of authority level, and coordinates workflow of cases outside authority limits with Senior Case Specialist....


  • FREMONT, United States Western & Southern Financial Group Full time

    Processes and reviews underwriting requirements by conducting customer interviews to gather non-medical and medical information. Works with some supervision but is empowered to approve applications and other decisions within the limits of authority level, and coordinates workflow of cases outside authority limits with Senior Case Specialist. Completes...

  • Direct Care Staff

    2 weeks ago


    Fremont, United States Friends of Children with Special Needs Full time

    Position: Direct Care StaffDepartment: Adaptive Supported Living Services (ASLS)Job Type: Part-Time/Full-Time Positions available.Pay: $20-$30/hourly, depending on experiences.JOB SUMMARY:Friends of Children with Special Needs (FCSN) is a nonprofit organization. FCSN Adaptive Supported Living Services (ASLS) is seeking an energetic, patient, detail-oriented,...

  • Direct Care Staff

    4 weeks ago


    Fremont, United States Friends of Children with Special Needs Full time

    Job DescriptionJob DescriptionSalary: $20-$30, depending on experiences.Position: Direct Care StaffDepartment: Adaptive Supported Living Services (ASLS)Job Type: Part-Time/Full-Time Positions available.Pay: $20-$30/hourly, depending on experiences.JOB SUMMARY:Friends of Children with Special Needs (FCSN) is a nonprofit organization. FCSN Adaptive Supported...


  • Fremont, United States Homeaide Home Care Full time

    We need a nighttime caregiver willing to work in Fremont Mon, Tue, Wed, Fri, Sat & Sun 10pm to 8pm.  The perfect candidate would have bedbound experience and be familiar with dialysis patients.  If you are interested in this case specifically please mention when contacting us.     HomeAide Home Care, Inc. was established in 1999 with the goal of treating...

  • Direct Care Staff

    2 weeks ago


    Fremont, United States Friends of Children with Special Needs Full time

    Position: Direct Care Staff (IHSS)Department: Adaptive Supported Living Services (ASLS)Job Type: Full time. Overnight from 10 PM to 9 AM. Non-exempt.Pay: $18.50/hourly.JOB SUMMARY:Friends of Children with Special Needs (FCSN) is a nonprofit organization. FCSN Adaptive Supported Living Services (ASLS) is seeking an energetic, patient, detail-oriented, and...

  • Direct Care Staff

    4 weeks ago


    Fremont, United States Friends of Children with Special Needs Full time

    Job DescriptionJob DescriptionSalary: $18.5/hourlyPosition: Direct Care Staff (IHSS)Department: Adaptive Supported Living Services (ASLS)Job Type: Full time. Overnight from 10 PM to 9 AM. Non-exempt.Pay: $18.50/hourly. JOB SUMMARY:Friends of Children with Special Needs (FCSN) is a nonprofit organization. FCSN Adaptive Supported Living Services (ASLS) is...