Case Manager RN
4 weeks ago
As a Case Manager RN with Kaiser Permanente, you will work collaboratively with physicians to coordinate and screen for the appropriateness of admissions and continued stays. You will make recommendations to physicians for alternate levels of care when patients do not meet the medical necessity for inpatient hospitalization. You will interact with families, patients, 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 and comply with AB 1203, Post Stabilization notification. You will also comply with other duties as described. Must be able to work collaboratively with the multidisciplinary team, multitask, and in a fast-paced environment.
Essential Responsibilities:
Plans, develops, assesses, and evaluates care provided to members. Collaborates 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. Recommends alternative levels of care and ensures compliance with federal, state, and local requirements. Assesses high-risk patients in need of post-hospital care planning. Develops and coordinates the implementation of a discharge plan to meet patients' identified needs; communicates the plan to physicians, patient, family/caregivers, staff, and appropriate community agencies. Reviews, monitors, evaluates, and coordinates patients' hospital stays to assure that all appropriate and essential services are delivered timely and efficiently. Participates in the Bed Huddles and carries out recommendations congruent with patients' needs. 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 for patients/families. Conducts 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. Acts as a liaison between in-patient facility and referral facilities/agencies and provides case management to patients referred. Refers patients to community resources to meet post-hospital needs. Coordinates transfer of patients to appropriate facilities; maintains and provides required documentation. Adheres to internal and external regulatory and accreditation requirements and compliance guidelines, including but not limited to: TJC, DHS, HCFA, CMS, DMHC, NCQA, and DOL. Educates members of the healthcare team concerning their roles and responsibilities in the discharge planning process and appropriate use of resources. Provides patients with education to assist with their discharge and help them cope with psychological problems related to acute and chronic illness. Per established protocols, reports any incidence of unusual occurrences related to quality, risk, and/or patient safety which are identified during case review or other activities. Reviews, analyzes, and identifies utilization patterns and trends, problems, or inappropriate utilization of resources and participates in the collection and analysis of data for special studies, projects, planning, or for routine utilization monitoring activities. Coordinates, participates, and/or facilitates care planning rounds and patient family conferences as needed. Participates in committees, teams, or other work projects/duties as assigned.
-
Case Manager Utilization RN
4 weeks ago
Fontana, California, United States Kaiser Permanente Full timeJob SummaryAs a 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. 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...
-
Travel Nurse Case Manager
4 weeks ago
Webster, NY , USA, United States TotalMed Case Management Staffing Full timeTotalMed Case Management Staffing is seeking a travel nurse RN Case Manager for a travel nursing job in New York.Job DetailsSpecialty: Case ManagementDiscipline: RNDuration: 13 weeks40 hours per weekShift: 8 hours, eveningsEmployment Type: TravelWe are seeking a Case Manager-Registered Nurse for an assignment in New York.TotalMed Case Management Staffing Job...
-
Travel Nurse Case Manager
4 weeks ago
Hwy , Savannah, GA, USA, 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: 13 weeks40 hours per weekShift: 8 hours, daysEmployment Type: TravelWe are seeking a Case Manager-Registered Nurse for an assignment in a dynamic healthcare environment.TotalMed Case Management...
-
Nurse Case Manager
4 weeks ago
Fontana, United States Kaiser Permanente Full timeKaiser Permanente is seeking a skilled Registered Nurse to fill a Case Management position in Fontana, California.Job Description & RequirementsSpecialty: Case ManagementDiscipline: RNDuration: Ongoing1 hours per weekShift: 8 hours, daysEmployment Type: Staff Job Summary: Works collaboratively with an MD to coordinate and screen for the appropriateness of...
-
Nurse Case Manager
4 weeks ago
Fontana, California, United States Kaiser Permanente Full timeJob SummaryAs a Registered Nurse - Case Management at Kaiser Permanente, you will work collaboratively with physicians to coordinate and screen for the appropriateness of admissions and continued stays. You will make recommendations to physicians for alternate levels of care when patients do not meet the medical necessity for inpatient hospitalization. You...
-
Senior Case Manager
2 months ago
Vista, CA, United States Professional Case Management Full timeMake a Difference on Your Own Schedule and Terms! Hiring Senior Case Managers in Washington Come join our growing team! A few of our perks: Create your own schedule!$44/hr. (including 100% of Hourly Wage Paid for All Drive Time) Bonus Eligible Direct assigned team members of RN Case Managers in the provision of care in accordance with Agency policy...
-
Case Manager Utilization RN, 20/hr Day
2 weeks ago
Fontana, United States Kaiser Permanente Full timeSign On for Eligible External Hires Job Summary: Works collaboratively with an MD to coordinate and screen for the appropriateness of admissions and Continued stays. Makes recommendations to the physicians for alternate levels of care when the patient does not meet the medical necessity for Inpatient hospitalization. Interacts with the family, patient and...
-
Case Manager Utilization RN, 20/hr Day
4 hours ago
Fontana, United States Kaiser Permanente Full timeSign On for Eligible External HiresJob Summary:Works collaboratively with an MD to coordinate and screen for the appropriateness of admissions and Continued stays. Makes recommendations to the physicians for alternate levels of care when the patient does not meet the medical necessity for Inpatient hospitalization. Interacts with the family, patient and...
-
RN Case Manager
1 month ago
Everett, WA , USA, United States Travel Nurse Across America Full timeCase Manager Travel Nurse Job DescriptionWe are seeking a skilled RN Case Manager to join our team of healthcare professionals at Travel Nurse Across America. As a Case Manager Travel Nurse, you will play a vital role in advocating for patients, evaluating their needs, and developing comprehensive care plans to ensure optimal outcomes.Key...
-
RN Case Manager
1 month ago
Washington, DC , USA, United States Travel Nurse Across America Full timeWe're seeking a skilled RN Case Manager to join our team at Travel Nurse Across America. As a RN Case Manager, you'll play a crucial role in advocating for patients, evaluating their needs, and developing comprehensive care plans. Your expertise will be essential in coordinating short and long-term care, reducing hospital stay lengths, and promoting...
-
Nurse Case Manager
1 month ago
Fontana, United States Kaiser Permanente Full timeJob Summary:As a Registered Nurse - Case Management at Kaiser Permanente, you will work collaboratively with physicians to coordinate and screen for the appropriateness of admissions and continued stays. You will make recommendations to physicians for alternate levels of care when patients do not meet medical necessity for inpatient hospitalization. You will...
-
RN Case Manager
4 weeks ago
Palm Springs, CA, United States Palm Careers LLC Full timePremier Health Care facility in Palm Springs, CA is hiring a Registered Nurse Manager for our Case Management Department. Located in the Coachella Valley Region of CA, our exclusive communities are know for their beautiful golf courses, world class resorts and spas.Our facility offers a guaranteed annual RN Education stipend Be paid to pursue your DSN or...
-
Travel Nurse RN Case Manager
4 weeks ago
US-, San Francisco, CA, USA GHR Healthcare - Travel Division Full timeGHR Healthcare - Travel Division is seeking a travel nurse RN Case Manager for a travel nursing job in a major California city.Job DetailsSpecialty: Case ManagementDiscipline: RNDuration: 13 weeks40 hours per weekShift: 8 hours, daysEmployment Type: TravelThe pay package is based on 8 hour shifts and 40 hours per week, with a tax-free stipend amount to be...
-
RN Utilization Manager
4 weeks ago
Fontana, California, United States Kaiser Full timeJob SummaryAs a Utilization Management RN, 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 medical necessity for inpatient hospitalization. You will interact with the...
-
Case Manager Utilization RN, 20/hr Day
3 weeks ago
Fontana, United States Kaiser Permanente Full timeSign On for Eligible External Hires Job Summary: Works collaboratively with an MD to coordinate and screen for the appropriateness of admissions and Continued stays. Makes recommendations to the physicians for alternate levels of care when the patient does not meet the medical necessity for Inpatient hospitalization. Interacts with the family, patient and...
-
AHD Case Manager RN
2 weeks ago
Alameda, CA, United States Alameda Health System Full timeSummary SUMMARY: The AHD Case Manager (RN) is responsible for providing comprehensive case management services to clients identified with complex health conditions and social challenges that are at risk for health status decline. The goals and focus of these service efforts are to provide timely delivery of intensive case management services during the...
-
Outpatient Case Manager RN
16 hours ago
Northridge, CA, United States REGAL MEDICAL GROUP, INC Full timePosition Summary: The Case Manager Outpatient RN is responsible for the assessment, treatment planning, intervention, monitoring, evaluation and documentation on identified High Risk members. The Case Manager Outpatient RN will assess and develop a care plan in collaboration with the admitting, attending and consulting physician, the member and other health...
-
AHD Case Manager RN
3 months ago
Alameda, CA, United States Alameda Health System Full timeSummary Role Overview: The AHD Case Manager (RN) is responsible for providing comprehensive case management services to clients identified with complex health conditions and social challenges that are at risk for health status decline. The goals and focus of these service efforts are to provide timely delivery of intensive case management services...
-
Travel Nurse RN Case Manager
4 weeks ago
US-, Edgewood, KY, USA MedPro Staffing Full timeMedPro Healthcare Staffing is seeking a travel nurse RN Case Management professional for a travel nursing job in a top healthcare facility.Job Description & RequirementsSpecialty: Case ManagementDiscipline: RNDuration: 13 weeks36 hours per weekShift: 8 hours, daysEmployment Type: TravelMedPro Healthcare Staffing, a Joint Commission-certified staffing agency,...
-
RN Case Manager
3 weeks ago
San Jose, CA, United States Aveanna Healthcare Full timeRN Case Manager - Clinical Supervisor Aveanna Healthcare is one of the nation’s largest home health care companies in the United States and growing! We are adding a RN Case Manager to join our clinical team in San Jose , CA . This position provides the opportunity to help develop and provide professional guidance to our field staff, as well...
