Kaiser Permanente
Patient Care Coordinator CM (UR-Discharge Planning)
Kaiser Permanente, San Francisco, California, United States, 94199
Patient Care Coordinator CM (UR-Discharge Planning)
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Patient Care Coordinator CM (UR-Discharge Planning)
role at
Kaiser Permanente
in San Francisco, CA.
Job Summary Coordinates with physicians, staff and non-Kaiser providers and facilities regarding patient transitions and discharge planning. In conjunction with physicians, develops plans of care and discharge plans, and makes recommendations for alternative levels of care as required.
Essential Responsibilities
Perform daily pre-admission, admission, and concurrent utilization reviews to determine appropriate levels of care and readiness for discharge.
Monitor the progression of discharge plans and facilitate discussions with multidisciplinary teams.
Educate other healthcare team members on utilization and care coordination.
Collaborate with and provide information to patients, families, physicians, and staff regarding discharge plans and transitions.
Consistently apply interpretation and utilization of member health care benefits.
Conduct UM, care coordination and discharge planning activities according to all applicable regulatory requirements.
Ensure continuity of care through communication in rounds and written documentation, level of care recommendations, transfer coordination, discharge planning, and obtaining authorizations/approvals for outside services.
Develop, evaluate, and coordinate a comprehensive discharge plan in conjunction with the patient/family, physician, nursing, social services, and other health care providers and agencies.
Basic Qualifications
Minimum four (4) years of experience in hospital patient care delivery, OR completion of a Masters degree in case management program in lieu of minimum years of experience.
Graduate of accredited school of nursing, or Diploma/Associate Degree Nursing.
Registered Nurse License (California).
Basic Life Support certification.
Additional Requirements
Knowledge of Nurse Practice Act, TJC, DMHC, CMS, NCQA, HIPAA, ERISA, EMTALA, and other applicable federal/state/local laws and regulations.
Strong communication and customer service skills, problem-solving, critical thinking, and clinical judgment abilities.
Fundamental word processing and computer navigation skills and ability to interpret and use analytic data in day-to-day operations.
Knowledge of healthcare benefits associated with various business lines (Medicare/KPSA, Commercial/KFH, Medi-Cal, Federal, etc.).
Must be able to work in a Labor/Management Partnership environment.
Preferred Qualifications
Minimum two (2) years of experience in utilization review, case management, and discharge planning.
Bachelor's degree in nursing or a health care related field.
Masters degree in case management.
Employment Type Full-time
Seniority Level Mid-Senior level
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Patient Care Coordinator CM (UR-Discharge Planning)
role at
Kaiser Permanente
in San Francisco, CA.
Job Summary Coordinates with physicians, staff and non-Kaiser providers and facilities regarding patient transitions and discharge planning. In conjunction with physicians, develops plans of care and discharge plans, and makes recommendations for alternative levels of care as required.
Essential Responsibilities
Perform daily pre-admission, admission, and concurrent utilization reviews to determine appropriate levels of care and readiness for discharge.
Monitor the progression of discharge plans and facilitate discussions with multidisciplinary teams.
Educate other healthcare team members on utilization and care coordination.
Collaborate with and provide information to patients, families, physicians, and staff regarding discharge plans and transitions.
Consistently apply interpretation and utilization of member health care benefits.
Conduct UM, care coordination and discharge planning activities according to all applicable regulatory requirements.
Ensure continuity of care through communication in rounds and written documentation, level of care recommendations, transfer coordination, discharge planning, and obtaining authorizations/approvals for outside services.
Develop, evaluate, and coordinate a comprehensive discharge plan in conjunction with the patient/family, physician, nursing, social services, and other health care providers and agencies.
Basic Qualifications
Minimum four (4) years of experience in hospital patient care delivery, OR completion of a Masters degree in case management program in lieu of minimum years of experience.
Graduate of accredited school of nursing, or Diploma/Associate Degree Nursing.
Registered Nurse License (California).
Basic Life Support certification.
Additional Requirements
Knowledge of Nurse Practice Act, TJC, DMHC, CMS, NCQA, HIPAA, ERISA, EMTALA, and other applicable federal/state/local laws and regulations.
Strong communication and customer service skills, problem-solving, critical thinking, and clinical judgment abilities.
Fundamental word processing and computer navigation skills and ability to interpret and use analytic data in day-to-day operations.
Knowledge of healthcare benefits associated with various business lines (Medicare/KPSA, Commercial/KFH, Medi-Cal, Federal, etc.).
Must be able to work in a Labor/Management Partnership environment.
Preferred Qualifications
Minimum two (2) years of experience in utilization review, case management, and discharge planning.
Bachelor's degree in nursing or a health care related field.
Masters degree in case management.
Employment Type Full-time
Seniority Level Mid-Senior level
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