Medical Care Specialist

2 weeks ago

Fontana, California, United States Kaiser Permanente Full time
Job Title: Medical Care Nurse

Kaiser Permanente is seeking a skilled Registered Nurse (RN) to join our team as a Case Manager in Fontana, California.

Job Summary:

We are looking for a dedicated and compassionate RN to provide high-quality care to our patients. As a Case Manager, you will be responsible for coordinating patient care, making recommendations for alternate levels of care, and ensuring compliance with federal, state, and local requirements.

Key Responsibilities:
  • Assess high-risk patients in need of post-hospital care planning
  • Develop and coordinate the implementation of a discharge plan to meet patients' identified needs
  • Collaborate with physicians, other members of the multidisciplinary healthcare team, and patient/family in the development, implementation, and documentation of appropriate, individualized plans of care
  • Recommends alternative levels of care and ensures compliance with regulatory requirements
  • 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
  • Conducts daily clinical reviews for utilization/quality management activities based on guidelines/standards for patients in a variety of settings
Requirements:
  • Two (2) years combined RN experience in an acute care setting or case management required
  • Completion of an accredited RN training program that allows graduates to take RN license exam
  • 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 in planning, organizing, conflict resolution, and negotiating skills
  • Computer literacy skills required
  • Bachelor's degree in nursing or healthcare-related field
About Kaiser Permanente:

Kaiser Permanente is a not-for-profit, integrated health plan that makes a difference in the lives of members, patients, and communities across the country. We are committed to advancing impactful and extraordinary care for all by pioneering health outcomes, encouraging diverse viewpoints, and creating new opportunities for learning and advancement.

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