Nurse Case Manager

4 weeks ago

Riverside, California, United States Kaiser Permanente Full time
Job Summary:
As a Registered Nurse - Case Management at Kaiser Permanente, you will work collaboratively with physicians to manage patients' specialized needs. Your duties will include assessing patients' needs, developing care management plans, and coordinating access to health services across multiple providers and disciplines. You will also monitor care, make determinations to arrange transportation and transfers, identify cost-effective measures, and promote self-care management.

Key Responsibilities:
Evaluates and identifies members' needs
Interfaces with Primary Care Physicians, Specialists, and various disciplines on the development of case management plans/programs
Monitors and evaluates the effectiveness of the case management plans and modifies as necessary
Coordinates the interdisciplinary approach to providing continuity of care, including utilization management, transfer coordination, discharge planning, and obtaining all authorizations/approvals/transfers as needed for outside services for patients/families
Acts as a clinical liaison with outside agencies such as County CCS, non-plan facilities, outside providers, employers, and/or workers compensation carriers and third-party administrators
Prepares reports, communicates program changes to appropriate staff, and develops protocols in accordance with state regulations
Acts as a patient advocate and educator to assure that the patient has the knowledge to care for their condition and is educated and empowered to be responsible for participating in the plan of care

Requirements:
Minimum two (2) years of clinical experience as an RN in an acute care or ambulatory care setting required
Bachelor's degree or equivalent experience four (4) years required
Current California RN license required
BLS required
Demonstrated ability to utilize/apply the general and specialized principles, practices, techniques, and methods of utilization review/management, care coordination, transfer coordination, 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 required
Computer literacy skills required
Bilingual (English/Spanish) QBS Level II required

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