Case Manager

As a Case Manager at Kaiser Permanente, you will play a vital role in providing case management and outreach services to selected patients. Your primary responsibility will be to provide discharge planning services and assist with follow-up for Health Plan members hospitalized at community hospitals. You will incorporate Risk Management, Quality Management, and Utilization Management concepts into daily hospital and clinic activities.

• Implement Continuing Care programs and initiatives with Continuing Care providers and PCP Team. Assist with integrating programs and initiatives into daily practice. Make clinic/location-specific adaptations as necessary to ensure successful implementation of the model. Monitor and evaluate outcomes.
• Provide case management services to targeted patients/families by interviewing and evaluating their needs. Develop work plans to assist patients/families in meeting identified needs. Coordinate resources and services to ensure continuity and quality of care. Maintain a working knowledge of community resources. Interpret Kaiser Permanente benefits/services to patients, families, and members of the community.
• Monitor high-risk members and assist them with access to care. Integrate patients into existing programs/services. Evaluate outcomes and make recommendations for change.
• Assist patients/families with identified problems/concerns.
• Meet with Continuing Care providers and PCP Team to monitor targeted patients. Assist the Team by coordinating community care. Explore options to ensure that quality, cost-efficient care is provided.
• Make daily hospital rounds for early identification of UM and discharge planning activities. Assist physician/patient/family in planning discharge to facilitate smooth transfer to home or alternate facility.
• Report any Risk/Quality/Utilization Management issues to Neighbor Island Management Team.
• Act as contact person for MOA/Oahu discharges. Assist patients with smooth transfer to home.
• Participate in community hospital interdisciplinary team meetings.
• Maintain confidentiality of all patient information.
• May perform patient care to the extent necessary to maintain clinical expertise, competency, and licensing necessary to fulfill job responsibilities and to direct the provision of care on the unit.
• Develop and maintain a collegial and consultative working relationship with Government Programs office staff to ensure that all regulatory requirements are met and necessary changes are implemented.
• Attend community seminars and workshops specific to professional needs. Participate in approved educational programs.
• Assist in developing, implementing, maintaining, evaluating, and enhancing Total Quality Management activities within the organization. Make suggestions for change/improvement as indicated.
• Incorporate the KP Nursing Vision, Model, and Values throughout their nursing practice.

• Minimum one (1) year of working with low-income/high-risk patients, preferably in a healthcare setting, including experience or successful completion of a training program (pre-hire, post-hire, or on-the-job) in the area of specialty, if applicable.
• Bachelor's degree in nursing OR four (4) years of experience in a directly related field.
• Registered Nurse License (Hawaii) required at hire.
• Basic Life Support from American Heart Association.

• Case management/community outreach experience.
• Demonstrated knowledge of and skill in oral communication, written communication, interpersonal relations, customer service, change management, multi-tasking, and problem-solving.
• Demonstrated knowledge of and skill in word processing, spreadsheet, and database PC applications.