Case Manager Utilization RN, Per Diem Night Position
4 weeks ago
As a Case Manager Utilization RN with Kaiser Permanente, you will collaborate with physicians to coordinate and screen for the appropriateness of admissions and continued stays. You will make recommendations to the physicians for alternate levels of care when the patient does not meet the medical necessity for inpatient hospitalization. You will interact with the family, patient, and other disciplines to coordinate a safe and acceptable discharge plan. You will function as an indirect caregiver, patient advocate, and manage patients in the most cost-effective way without compromising quality. You will transfer stable non-members to planned healthcare facilities. You will be responsible for complying with AB 1203, Post Stabilization notification. You will comply with other duties as described. You must be able to work collaboratively with the multidisciplinary team, multitask, and in a fast-paced environment.
Key Responsibilities:- Plan, develop, assess, and evaluate care provided to members.
- 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 to ensure continuity, quality, and appropriate resource use.
- Recommend alternative levels of care and ensure compliance with federal, state, and local requirements.
- 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; communicate the plan to physicians, patient, family/caregivers, staff, and appropriate community agencies.
- Review, monitor, evaluate, and coordinate patients' hospital stays to assure that all appropriate and essential services are delivered timely and efficiently.
- Participate in the Bed Huddles and carry out recommendations congruent with patients' needs.
- Coordinate 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.
- Conduct daily clinical reviews for utilization/quality management activities based on guidelines/standards for patients in a variety of settings, including outpatient, emergency room, inpatient, and non-KFH facilities.
- Act as a liaison between in-patient facility and referral facilities/agencies and provide case management to patients referred.
- Refer patients to community resources to meet post-hospital needs.
- Coordinate transfer of patients to appropriate facilities; maintain and provide required documentation.
- Adhere to internal and external regulatory and accreditation requirements and compliance guidelines, including but not limited to: TJC, DHS, HCFA, CMS, DMHC, NCQA, and DOL.
- Educate members of the healthcare team concerning their roles and responsibilities in the discharge planning process and appropriate use of resources.
- Provide patients with education to assist with their discharge and help them cope with psychological problems related to acute and chronic illness.
- Per established protocols, report any incidence of unusual occurrences related to quality, risk, and/or patient safety which are identified during case review or other activities.
- Review, analyze, and identify utilization patterns and trends, problems, or inappropriate utilization of resources and participate in the collection and analysis of data for special studies, projects, planning, or for routine utilization monitoring activities.
- Coordinate, participate, and/or facilitate care planning rounds and patient family conferences as needed.
- Participate in committees, teams, or other work projects/duties as assigned.
- 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.
- Registered Nurse License (California)
- Basic Life Support
- 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 to utilize written and verbal communication, interpersonal, critical thinking, and problem-solving skills.
- Demonstrated ability in planning, organizing, conflict resolution, and negotiating skills.
- Computer literacy skills required.
- Bachelor's degree in nursing or healthcare-related field.
Notes:
- Varies Sunday-Saturday
- 12 hour shifts, Minimum availability 5 shifts per quarter with 2 being weekends
- Minimum availability 5 shifts per quarter with 2 being weekends
-
RN Case Manager, Per Diem Position
4 weeks ago
Los Angeles, California, United States University of California Full timeMake a Meaningful Difference in Patients' LivesAs a RN Case Manager at UCLA Health, you will have the opportunity to make a significant, positive impact on patients' lives. Our team is dedicated to delivering high-quality, patient-centered care, and we are seeking a self-directed, creative problem solver to join our ranks.Key Responsibilities:Assess and...
-
Travel Nurse RN Case Management Position
4 weeks ago
Los Angeles, California, United States TotalMed Case Management Staffing Full timeTotalMed Case Management Staffing is seeking a travel nurse RN Case Management professional for a travel nursing position in California.Job DetailsSpecialty: Case ManagementDiscipline: RNDuration: 13 weeks40 hours per weekShift: 8 hours, daysEmployment Type: TravelTotalMed Case Management Staffing is a leading provider of travel nursing services, and we are...
-
Traveling Registered Nurse
4 weeks ago
Los Angeles, California, United States Forhyre Full timeJob DescriptionForhyre is seeking an experienced Travel RN Case Manager for Utilization Review in a dynamic healthcare environment.Key Responsibilities:Conduct thorough utilization reviews to assess patient admissions and continued stays.Collaborate with healthcare teams to develop and implement individualized care plans.Ensure compliance with regulatory...
-
Case Manager Utilization RN
4 weeks ago
Los Angeles, California, United States Kaiser Permanente Full timeJob Summary: We are seeking a skilled RN Utilization Case Manager to join our team at Kaiser Permanente. In this role, you will work collaboratively with physicians to coordinate and screen for the appropriateness of admissions and continued stays. You will make recommendations to the physicians for alternate levels of care when the patient does not meet the...
-
Travel Nurse RN Case Management Position
4 weeks ago
Los Angeles, California, United States TotalMed Case Management Staffing Full timeJob Title: Travel Nurse RN Case Management PositionJob Summary:TotalMed Case Management Staffing is seeking a travel nurse RN case management professional for a travel nursing job in a dynamic healthcare setting. As a travel nurse RN case manager, you will be responsible for providing high-quality patient care and case management services to patients in...
-
Complex Case Manager Utilization RN
4 weeks ago
Los Angeles, California, United States Kaiser Permanente Full timeJob Summary:As a Complex Case Manager Utilization RN at Kaiser Permanente, you will work collaboratively with physicians to coordinate and screen for the appropriateness of admissions and continued stays. Your expertise will be utilized to make recommendations for alternate levels of care when patients do not meet the medical necessity for inpatient...
-
Nurse Case Manager
1 month ago
Los Angeles, California, United States Incredible Health Full timeIncredible Health is actively hiring for a Registered Nurse position in the Los Angeles, CA area. The ideal candidate will have experience in emergency department case management, clinical pathway navigation, or utilization review. This is a full-time, part-time, or per diem opportunity with a competitive salary range of $71,000 to $151,000 per year....
-
RN Case Manager Utilization Specialist
4 weeks ago
Los Angeles, California, United States Kaiser Permanente Full timeJob Summary:Kaiser Permanente seeks a skilled RN Case Manager Utilization Specialist to coordinate and screen for the appropriateness of admissions and continued stays. This role requires collaboration with physicians to make recommendations for alternate levels of care when patients do not meet medical necessity for inpatient hospitalization. The ideal...
-
Travel Nurse RN Case Manager
4 weeks ago
Los Angeles, California, United States TotalMed Case Management Staffing Full timeTotalMed Case Management Staffing is seeking a travel nurse RN Case Management professional for a travel nursing assignment in California.Job DetailsSpecialty: Case ManagementDiscipline: RNDuration: 13 weeks40 hours per weekShift: 8 hours, daysEmployment Type: TravelWe are looking for a skilled Case Manager-Registered Nurse to join our team in...
-
Travel Nurse RN Case Manager
1 month ago
Los Angeles, California, United States TotalMed Case Management Staffing Full timeTotalMed Case Management Staffing is seeking a travel nurse RN Case Manager for a travel nursing job.Job Description & RequirementsSpecialty: Case ManagementDiscipline: RNEmployment Type: TravelWe are seeking a Case Manager-Registered Nurse for an assignment.TotalMed Case Management Staffing Job ID #1643971. Pay package is based on 12 hour shifts and 36...
-
Travel Nurse RN Case Manager
4 weeks ago
Los Angeles, California, United States TotalMed Case Management Staffing Full timeTotalMed Case Management Staffing is seeking a travel nurse RN Case Manager for a travel nursing job.Job Description & RequirementsSpecialty: Case ManagementDiscipline: RNDuration: 13 weeks, 40 hours per weekShift: 8 hours, daysEmployment Type: TravelWe are seeking a Case Manager-Registered Nurse for an assignment in California.Pay package is based on 8 hour...
-
Travel Nurse RN Case Manager
4 weeks ago
Los Angeles, California, United States TotalMed Case Management Staffing Full timeTotalMed Case Management Staffing is seeking a travel nurse RN Case Management professional for a travel nursing assignment in California.Job Description & RequirementsSpecialty: Case ManagementDiscipline: RNShift: 12 hours, daysEmployment Type: TravelWe are looking for a skilled Case Manager-Registered Nurse for an assignment in California.TotalMed Case...
-
RN Manager of Utilization Management
4 weeks ago
Los Angeles, California, United States healthcarerecruitmentpartners Full timeJob Title: RN Manager of Utilization ManagementJob Summary:Healthcare Recruitment Partners is seeking a skilled RN Manager of Utilization Management to oversee the coordination of services through an interdisciplinary process. The ideal candidate will have experience in case management leadership and be able to balance patient needs with cost-effective...
-
Travel Nurse Case Manager
4 weeks ago
Los Angeles, California, United States TotalMed Case Management Staffing Full timeTotalMed Case Management Staffing is seeking a travel nurse RN Case Manager for a travel nursing job.Job DetailsSpecialty: Case ManagementDiscipline: RNDuration: 16 weeks40 hours per weekShift: 8 hours, daysEmployment Type: TravelWe are seeking a Case Manager-Registered Nurse for an assignment in California.TotalMed Case Management Staffing Job ID #1597463....
-
Travel Nurse RN Case Manager
4 weeks ago
Los Angeles, California, United States TotalMed Case Management Staffing Full timeJob Title: Travel Nurse RN Case ManagerJob Summary:TotalMed Case Management Staffing is seeking a travel nurse RN case manager for a travel nursing job in a dynamic healthcare setting. As a case manager, you will be responsible for coordinating patient care and ensuring seamless transitions between healthcare providers. This is a great opportunity to work...
-
Case Manager RN
1 week ago
Los Angeles, California, United States Incredible Health Full timeJob OverviewIncredible Health is actively hiring for a Registered Nurse - Case Manager position in the Los Angeles area.Estimated Salary RangeThe estimated salary for this role is between $62,000 and $110,000 per year, based on industry standards and location.Job DescriptionWe are seeking experienced nurses who can manage clinical pathways, navigate patient...
-
RN Manager of Utilization Management
4 weeks ago
Los Angeles, California, United States Healthcare Recruitment Partners Full timeJob DescriptionUtilization Management RN ManagerHealthcare Recruitment PartnersThe RN Manager of Utilization Management is responsible for overseeing the coordination of services through an interdisciplinary process. This role expands the Care Management focus, balancing individually identified patient and family needs with cost-effective utilization of...
-
Travel Nurse Case Manager
4 weeks ago
Los Angeles, California, United States TotalMed Case Management Staffing Full timeTotalMed Case Management Staffing is seeking a travel nurse RN Case Management professional for a travel nursing opportunity in California.Job DetailsSpecialty: Case ManagementDiscipline: RNDuration: 13 weeks40 hours per weekShift: 8 hours, daysEmployment Type: TravelTotalMed Case Management Staffing is a leading provider of travel nursing opportunities...
-
Case Manager Utilization RN, 24/hr Mid-Shift
4 weeks ago
Los Angeles, California, United States Kaiser Permanente Full timeJob Summary:As a Utilization Case Manager RN at Kaiser Permanente, you will work collaboratively with physicians to coordinate and screen for the appropriateness of admissions and continued stays. Your recommendations will help physicians determine alternate levels of care for patients who do not meet the medical necessity for inpatient...
-
Travel Nurse RN Case Management Position
4 weeks ago
Los Angeles, California, United States Anders Group Full timeAnders Group is seeking a travel nurse RN Case Management professional for a dynamic travel nursing opportunity.Job Description & RequirementsSpecialty: Case ManagementDiscipline: RN36 hours per weekShift: 12 hoursEmployment Type: TravelAbout Anders GroupWe are a Joint Commission accredited staffing agency dedicated to providing exceptional customer service...
