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Inpatient Care Manager
2 months ago
Job Summary:
The Inpatient Care Manager serves as a liaison between Kaiser Permanente and healthcare providers, ensuring seamless transitions of care and facilitating open communication. This role is responsible for supervising and managing teams of personnel who support utilization management, transitions of care, and discharge planning activities.
Key Responsibilities:
- Establish and maintain relationships with healthcare providers, staff, and faculty to promote effective communication and collaboration.
- Develop and implement strategies to ensure compliance with regulatory accreditation standards, including NCQA, state, and federal requirements.
- Manage and direct Patient Care Coordinators and support staff to ensure utilization management and discharge planning activities are applied consistently and effectively.
- Oversee day-to-day activities of assigned staff, including staff scheduling, caseload assignment, and resource utilization.
- Ensure accurate interpretation and application of member benefits, adhering to state and federal regulations.
- Conduct case-level reviews and provide feedback to Patient Care Coordinator staff on a regular basis.
- Participate in multidisciplinary rounds to ensure smooth transitions of care to alternative levels of care.
- Support professional growth by providing education, training, and resources to direct reports.
- Conduct performance evaluations, provide coaching, and act as a mentor to direct reports.
Work Environment:
This role requires a Monday to Friday schedule with a weekend on-call rotation.
Scope of Responsibility:
The Inpatient Care Manager will have oversight of utilization management activities across multiple healthcare facilities.
Requirements:
- Experience: Minimum of five years of experience in a clinical setting, with at least two years of experience in utilization management or case management.
- Education: Bachelor's degree in nursing, healthcare administration, or a related field.
- License, Certification, Registration: Registered Nurse License (Virginia) within six months of hire, and Registered Nurse License (Maryland) within six months of hire.
Preferred Qualifications:
- Experience working with various member populations in a community setting.
- Knowledge of Kaiser Permanente or other integrated healthcare delivery systems.
- Working knowledge of Kaiser Permanente or experience working with state Medicaid/Medicare plans.
- Certification in Case Management from Commission for Case Manager Certification or Nursing Case Manager Certification from American Nurses Credentialing Center.
- Master's degree in nursing, healthcare administration, or a related field.
