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Clinical Care Coordinator

2 months ago

Wailuku, Hawaii, United States CMP Full time
Job Summary:
As a skilled Clinical Care Coordinator at CMP, you will play a vital role in ensuring seamless patient care transitions. You will work closely with physicians, staff, and external providers to coordinate patient care, develop plans of care, and monitor clinical activities. Your expertise will help identify cost-effective protocols and develop guidelines for care.

Key Responsibilities:
  • Conduct daily pre-admission, admission, and concurrent utilization reviews to determine appropriate levels of care and readiness for discharge. Escalate utilization and system problems that require immediate attention. Perform rounds and review patient admissions under the Kaiser Skilled Nursing Facility (SNF) benefit. Utilize knowledge of Medicare regulations and Health Plan benefits to determine medical necessity.
  • Ensure continuity of care for outside services for the patient. Monitor level of care and develop, evaluate, and coordinate comprehensive discharge plans in conjunction with the patient/family, physician, nursing, social services, and other healthcare providers and agencies.
  • Monitor care processes and participate in the development and implementation of guidelines, pre-printed physician orders, care paths, etc. for patient care. Identify opportunities for cost-savings and improvements in the quality of care across the continuum. Establish and maintain effective relationships between Kaiser Permanente and community facilities.
  • May perform patient care to the extent necessary to maintain clinical expertise, competency, and licensing necessary to fulfill job responsibilities and direct the provision of care on the unit.
  • Provide direct patient care on an as-needed basis, ensuring services are within scope of license and in compliance with all legal, regulatory, and policy requirements relevant to the clinical role performed.
  • Incorporate the KP Nursing Vision, Model, and Values throughout their Nursing Practice.

Requirements:
  • Four (4) years of acute or sub-acute inpatient care experience.
  • One (1) year of Care Management experience or successful completion of the MHS Case Management Internship within 6 months of hire.
  • Bachelor's degree in nursing or four (4) years of directly related experience.
  • Basic Life Support or CPR/AED for Professional Rescuers.
  • Registered Nurse License (Hawaii).

Preferred Qualifications:
  • Minimum two (2) years of experience in Care Management.
  • Professional certification in Case Management.
  • Masters Degree in healthcare administration, nursing, or related field.