Patient Care Coordinator
4 weeks ago
As a Patient Care Coordinator at Kaiser Permanente, you will play a critical role in ensuring seamless transitions for patients. You will work closely with physicians, staff, and non-Kaiser providers to coordinate care and develop discharge plans. Your expertise will be essential in determining appropriate levels of care and readiness for discharge.
Key Responsibilities:
Utilization Management:
Conduct daily pre-admission, admission, and concurrent utilization reviews to determine the most suitable levels of care. Collaborate with multidisciplinary teams to monitor the progression of discharge plans and facilitate discussions. Educate healthcare team members on utilization and care coordination best practices.
Provide patients, families, physicians, and staff with clear information regarding discharge plans and transitions. Ensure a thorough understanding of member healthcare benefits and consistently apply regulatory requirements.Discharge Planning:
Develop, evaluate, and coordinate comprehensive discharge plans in conjunction with patients, families, physicians, and other healthcare providers. Ensure continuity of care through effective communication and documentation.
Coordinate transfer arrangements and obtain necessary authorizations/approvals for outside services. Conduct reviews and updates to discharge plans as needed.Regulatory Compliance:
Conduct utilization, care coordination, and discharge planning activities in accordance with all applicable regulatory requirements. Kaiser Permanente reserves the right to reevaluate and change job descriptions or convert positions from salaried to hourly pay status. Changes will be implemented after notice to affected employees.
Qualifications:
Minimum four (4) years of experience in hospital patient care delivery or completion of a Master's degree in case management. Graduate of an accredited school of nursing with a Diploma/Associate Degree in Nursing. Registered Nurse License (California) required.
Knowledge of the Nurse Practice Act, TJC, DMHC, CMS, NCQA, HIPAA, ERISA, EMTALA, and other applicable federal/state/local laws and regulations. Strong communication and customer service skills, problem-solving, critical thinking, and clinical judgment abilities. Proficiency in word processing and computer navigation skills, with the ability to interpret and use analytic data in daily operations. Knowledge of healthcare benefits associated with various business lines (Medicare/KPSA, Commercial/KFH, Medi-Cal, Federal, etc.). Ability to work in a Labor/Management Partnership environment.Preferred Qualifications:
Minimum two (2) years of experience in utilization review, case management, and discharge planning. Bachelors degree in nursing or a healthcare-related field. Masters degree in case management preferred.
Location:
San Jose, California
Job Type:
Full-time
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