Case Manager Utilization RN
3 days ago
We are seeking a skilled and compassionate Case Manager Utilization RN to join our team at Kaiser Permanente. As a key member of our multidisciplinary team, you will work collaboratively with physicians and other healthcare professionals to coordinate and screen for the appropriateness of admissions and continued stays.
Key Responsibilities- Develop and implement individualized plans of care to ensure continuity, quality, and appropriate resource use.
- Collaborate with physicians, other members of the healthcare team, and patients/families to develop, implement, and document plans of care.
- Assess high-risk patients in need of post-hospital care planning and develop and coordinate the implementation of discharge plans to meet patients' identified needs.
- Communicate plans to physicians, patients, families/caregivers, staff, and appropriate community agencies.
- Review, monitor, evaluate, and coordinate patients' hospital stays to ensure timely and efficient delivery of essential services.
- Participate in bed huddles and carry out recommendations congruent with patients' needs.
- Coordinate the interdisciplinary approach to providing continuity of care, including utilization management, transfer coordination, discharge planning, and obtaining authorizations/approvals as needed for outside services.
- Conduct daily clinical reviews for utilization/quality management activities based on guidelines/standards for patients in various settings.
- Act as a liaison between in-patient facilities and referral facilities/agencies and provide case management to patients referred.
- Refer patients to community resources to meet post-hospital needs and coordinate transfers to appropriate facilities.
- Two (2) years combined RN experience in an acute care setting or case management required.
- Completion of an accredited RN training program that allows graduates to take RN license exam.
- Registered Nurse License (California) and Basic Life Support certification required.
- Demonstrated ability to utilize/apply the general and specialized principles, practices, techniques, and methods of utilization review/management, 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.
- Demonstrated ability in planning, organizing, conflict resolution, and negotiating skills.
- Computer literacy skills required.
- Bachelor's degree in nursing or healthcare-related field.
Every other weekend.
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