Continuing Care Utilization Review Coordinator RN
1 week ago
Kaiser Permanente is seeking a skilled Utilization Review Coordinator RN to join our team. As a key member of our healthcare team, you will be responsible for conducting utilization reviews for in-house patients and/or those members at contracted facilities. Your expertise will be essential in assisting with the discharge planning process and ensuring that our patients receive the highest quality care.
Essential Responsibilities:- Conduct thorough utilization reviews for in-house patients and/or members who have been admitted to contracted facilities, gathering information and insights to inform care decisions.
- Interview patients and caregivers to understand their needs and preferences, and provide guidance on post-hospitalization care.
- Collaborate with physicians to review clinical data and ensure that care is aligned with established treatment criteria.
- Identify trends and areas for improvement in utilization patterns, and contribute to quality improvement initiatives.
- Assist in collecting and analyzing clinical data to enhance the quality of services and inform care decisions.
- Develop and implement quality improvement plans to address areas of concern.
- Investigate and report on unusual occurrences and questionable decisions, using your expertise to inform care decisions.
- Work closely with healthcare providers to facilitate discharge planning and triage patients to alternative units of care.
- Counsel patients on Medicare and health plan coverage, and coordinate referrals to relevant agencies and facilities.
- Minimum two (2) years of experience in an inpatient setting or two (2) years of experience in a skilled nursing facility.
- Minimum one (1) year of utilization experience required.
- Bachelor's degree in nursing or a health-related field required, or four (4) years of experience in a directly related field.
- Graduate of an accredited school of nursing.
- High School Diploma or General Education Development (GED) required.
- Driver's License (California).
- Registered Nurse License (California).
- Basic Life Support.
- Demonstrated knowledge of diagnostic codes.
- Ability to work in a Labor/Management Partnership environment.
- Clinical expertise in the area of review preferred.
- Masters degree preferred.
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San Francisco, California, United States Kaiser Permanente Full timeJob Summary:Kaiser Permanente is seeking a skilled Utilization Review Coordinator RN to join our team. As a key member of our healthcare team, you will be responsible for conducting utilization reviews for in-house patients and/or those members at contracted facilities. Your expertise will be essential in assisting with the discharge planning process and...
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San Francisco, California, United States Kaiser Permanente Full timeJob Summary:Kaiser Permanente is seeking a skilled Utilization Review Coordinator RN to join our team. As a key member of our healthcare team, you will be responsible for conducting utilization reviews for in-house patients and/or those members at contracted facilities. Your expertise will be essential in assisting with the discharge planning process and...
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San Carlos, California, United States Kaiser Full timeJob Summary:Kaiser Permanente seeks a skilled Utilization Review Coordinator RN to conduct thorough reviews of patient care and assist in discharge planning. This role requires strong clinical expertise and excellent communication skills.Key Responsibilities:Conduct utilization reviews for in-house patients and/or members at contracted facilities.Interview...
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San Francisco, California, United States Kaiser Full timeJob Summary: Conducts utilization review for in-house patients and/or those members at contracted facilities. Assists in the discharge planning process.Essential Responsibilities: Conducts utilization review for in-house patients and/or members who have been admitted to contracted facilities. Interviews patients/caregivers regarding care after...
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San Carlos, California, United States Kaiser Full timeJob Summary:Kaiser Permanente seeks a skilled Utilization Review Coordinator RN to conduct thorough reviews of patient care and assist in discharge planning. This role requires strong clinical expertise and excellent communication skills.Key Responsibilities:Conduct utilization reviews for in-house patients and/or members at contracted facilities.Interview...
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