Inpatient Utilization Review Specialist RN

1 week ago


Walnut Creek, California, United States Kaiser Permanente Full time
Job Summary

Kaiser Permanente is seeking a skilled Inpatient Utilization Review Specialist RN to conduct reviews for in-house patients and/or those members at contracted facilities. This role plays a crucial part in the discharge planning process.

Key Responsibilities
  • Conduct thorough utilization reviews for in-house patients and/or members who have been admitted to contracted facilities, interviewing patients/caregivers regarding care after hospitalization.
  • Collaborate with physicians on clinical reviews, keeping them informed of Kaiser clinical criteria.
  • Identify trends and problem areas through review of utilization patterns.
  • Assist in collecting and assimilating clinical data to enhance service quality.
  • Generate quality improvement results and investigate unusual occurrences.
Secondary Functions
  • This role requires working Sun-Thur, alternating weekends.
Basic QualificationsExperience
  • A minimum of two years' experience in an inpatient setting or two years in a skilled nursing facility.
  • One year of utilization experience required.
Education
  • Bachelor's degree in nursing or a related field required.
  • Graduate of an accredited school of nursing.
Licenses, Certifications, Registrations
  • California Registered Nurse License.
  • Basic Life Support Certification.
Estimated Salary: $85,000 - $110,000 per yearAbout Us

Kaiser Permanente is a leader in healthcare innovation and patient-centered care. As a valued member of our team, you will be empowered to make a meaningful difference in the lives of our patients.



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