RN, Telephonic Inpatient Coordinator ( Remote- On-Call)
Atlanta, GeorgiaAt Kaiser Permanente our nurses are leaders, clinicians, researchers, innovators, and scientists who are contributing toward being an industry-leading voice for advancing evidence-based care. Whether supporting the patient directly in our hospitals or clinics, providing care at home, serving our patients through innovative virtual technology, or managing care delivery teams, Kaiser Permanente nurses utilize scientific evidence and our integrated care model to optimize the total health of our members and the communities we serve. We invite nurses who are passionate about nursing excellence, high-quality compassionate care delivery, professionalism, integrity, teamwork and patient and family centeredness to join our teams so that we can continue to sustain and build upon our culture of excellence.
- Job Type: Call-in/On-Call
- Job Level: Entry Level
- Travel: Yes, 100 % of the Time
Success Profile
We’re looking for Nurse Leaders who possess the following traits.
- Collaborative
- Compassionate
- Flexible
- Leadership
- Socially Conscientious
- Trustworthy
Benefits
We offer several benefits to our nurses.
-
Medical, Vision & Dental
-
Retirement Plans
-
Educational Opportunities & Tuition Reimbursement
-
Supportive Teams & Resources
-
Career Growth & Development
Our Culture
At Kaiser Permanente, we cultivate an environment of compassion, integrity, trust, and open communication that helps our teams do their best work. We believe that lifelong learning will expand our knowledge so we can better serve our patients. Our practice is rooted in research and evidence-based care. Our nurses reflect the rich diversity of our members and communities and provide culturally responsive and competent care that promotes understanding of our members needs and preferences. At Kaiser Permanente, nurses are highly skilled professionals who exemplify leadership, critical thinking, and collaborative problem solving and deliver the right care, at the right time, in the right setting.
What Our People Are Saying
Kristen
Relief Charge Nurse
“Working as a nurse at Kaiser Permanente has allowed me the perfect flexible schedule so that I can volunteer as Girl Scout Leader and room parent for both my children. My kids know that I am a hardworking mother who can provide, as well as a mom who can be present and be there for them – and that means everything to me.”
Jazmin
RN, Advice Nurse
“Working for Kaiser Permanente has allowed me to take control of my future and make my goals a possibility. I feel that Kaiser Permanente allows me to keep climbing and moving. Having that ability truly makes me feel empowered.”
Stella
Registered Nurse IV
“Kaiser Permanente has taken me on a personal and educational growth journey. I am supported by a culture of excellence that allows me to be dedicated to patients and patients’ families every day at work. What an honor to be part of Kaiser Permanente.”.
Caitlin
Inpatient Lactation Consultant
“As an RN/IBCLC in Maternal Child, I’m meeting families at a pivotal time — I’m there to help launch a new family into the world. Everything I do has the potential to impact a family’s health for generations to come.”
Kimberly
Quality Coordinator RN
“In Hawaii, your community is your family — or ‘ohana.’ I am able to provide extraordinary patient-centered care to my ohana.”
David
Appointment and Advice RN
“The location is fantastic. Kaiser Permanente is all over the country. You can pick almost any environment you want – from ocean to mountain to city. You’ll still be able to contribute to our mission of providing high quality health care at a local facility.”
Shawn
BSN, RN
“I chose Kaiser Permanente because their staff and providers really show that they care about you. Also, throughout my 12 years of working here I’m always learning something new, and I’ve had many opportunities for growth and development.”
RN, Telephonic Inpatient Coordinator ( Remote- On-Call)
Navigating the Hiring Process
We're here to support you!
Having trouble with your account or have questions on the hiring process?
Please visit the FAQ page on our website for assistance.
Need help with your computer and browser settings?
Please visit the Technical Information page for assistance or reach out to the web manager at kp-hires@kp.org.
Do you need a reasonable accommodation due to a disability?
A reasonable accommodation is any modification or adjustment that enables you to fully participate in completing the following:
- Online Submissions
- Pre-Hire Assessments
- Interview Process
Please submit your accommodation request and an HR Representative will contact you.
Responsible for carrying out utilization review, quality review and discharge planning on inpatient admissions at facilities without QRM review staff onsite according to policy. The activities will include telephonic initial admission and concurrent review for inpatient admissions, discharge planning, identification of patients for case management, communication with case managers, home care reviewers, Social Workers, providers, and members as indicated, quality improvement reviews, and education of the member/family, provider and hospital staff. Achieves desired utilization and quality outcomes and promotes high customer satisfaction to the population served.
- Responsible for the day to day inpatient review activities as outlined above.
- Utilizes established criteria, performs prospective, concurrent and retrospective utilization review for all members requiring inpatient admission.
- Reviews all new inpatient admissions within 24 hours and begins the discharge planning process immediately.
- Reviews all inpatients at a minimum of every 3 days and more frequently as appropriate based on criteria and policy.
- Coordinates case conferences involving multidisciplinary teams to handle complicated cases.
- Understands the Complex and Transitional Case Management and Specialty Care Programs and admission criteria and refers patients to the Case Managers and specialty care programs as appropriate.
- Attends scheduled weekly and daily telephonic rounds with physician reviewer to discuss clinical course, discharge planning and potential QA/UM concerns of all hospitalized patients.
- Interacts with physicians to ensure that resources are being utilized appropriately while maintaining quality outcomes.
- Establishes and maintains contact with patients and their families as appropriate, including the provision of education when needed.
- May request psychosocial assessments on all patients that meet the high risk indicators for discharge planning. Refers the patient to the complex case managers, home care review team and/or social workers as appropriate.
- Arranges follow up appointments for medical and surgical patients who are discharged home as needed.
- Ensures that the appropriate level of care is being delivered in the most appropriate setting.
- Performs quality of care and service reviews using identified quality indicators.
- Coordinates and assists the Supervisor of Telephonic Inpatient Care Coordination with ongoing physician education.
- Reviews the monthly analysis of statistics (cost/benefit) with the Supervisor of Telephonic Inpatient Care Coordination and makes adjustments based on findings.
- Remains knowledgeable of contract benefits and current, relevant state and Federal regulations, criteria, documentation requirements and laws that affect managed care and case/utilization management.
- Maintains effective interaction/communication with members of the medical staff, nursing staff, complex case managers, home care review team, social workers, general reviewers, referral coordinators, and Kaiser Permanente medical offices to facilitate the inpatient utilization management process and to provide continuity of care.
- Builds effective working relationships with physicians, SNF staff, vendors, and other departments within the health plan.
- Assists in the development and revision of guidelines, pathways and protocols.
- Attends QRM staff meetings, Joint Case Management Meetings and weekly Complex Care Teleconferences as required.
- Investigates, identifies and reports problems and inefficiencies in existing systems, and recommends changes when appropriate to the Supervisor of Telephonic Inpatient Care Coordination.
- Under the guidance of the Supervisor of Telephonic Inpatient Care Coordination and in consultation with other QRM staff, participates in the coordination, planning, development, implementation, and maintenance of all QRM policies and procedures related to the Telephonic Inpatient Review Program.
- Monitors utilization trends concerning inpatient care in the market area, keeping appropriate management informed. Initiates recommendations to facilitate reductions in utilization to include repatriation when appropriate.
- Refers cases identified as risk management, peer review or quality issues to QAIR and Risk Management.
- Document Review Activities to include (according to policy): Medical necessity for admission, Medical necessity for continued stay, Estimated length of stay, Diagnoses, Procedures performed, Demographic Data, Discharge Planning, Physicians involved in care, Other
- Issue letters of non - coverage to members not meeting inpatient level of care criteria per established criteria and policy and procedure.
- Works cross-functionally with other departments in striving to meet organizational goals and objectives.
- Participates in call rotation to provide case management support after hours and on weekends.
- Achieves and maintains an understanding of relevant state and federal regulations, criteria, and documentation requirements and laws that affect managed care, home health and case/utilization management.
- Knowledgeable and compliant with regional personnel policies and procedures.
- Knowledgeable and compliant with QRM departmental and unit specific policies and procedures.
- Participates in annual regional and departmental compliance training.
- Knowledgeable and compliant with Principles of Responsibility.
- Responsible for assisting the Medical Office Administration, Customer Services and Provider Relations in investigating concerns and issues.
- Access to protected health information (PHI) will be limited to the minimum necessary required to effectively perform the job.
- Demonstrates understanding of HIPAA privacy regulations by maintaining confidentiality of Protected Health Information (PHI).
- Demonstrates doing the right thing and doing things the right way is an underlying premise in all work related activities and is able to identify location of copy of Principles of Responsibility.
- Develops and maintains an awareness of how to report compliance issues and concerns. Identifies issues of wrong doing and promptly investigates and reports to immediate supervisor or Director of Regional Compliance. Assures an atmosphere and culture for staff to report issues of wrong doing.
- Other duties as assigned.
- Three (3) years of clinical nursing.
- B.S. in Nursing or four (4) years directly related experience.
- High school diploma or GED required.
- Registered Professional Nurse License (Georgia) required at hire
- Working knowledge of all relevant federal, state, local and regulatory requirements, including Medicare.
- Functional knowledge of computers.
- Experience in ICD9/CPT4 coding.
- CCM preferred.
- Preferred three (3) years of clinical nursing with preferred experience in a complex area such as critical care.
- Preferred experience with managed care or health care delivery systems.
- Preferred two (2) years of experience in utilization or case management, discharge planning and quality improvement in a managed care or health care setting preferred.
- B.S. in Nursing.
Kaiser Permanente is an equal opportunity employer committed to a diverse and inclusive workforce. Applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), age, sexual orientation, national origin, marital status, parental status, ancestry, disability, gender identity, veteran status, genetic information, other distinguishing characteristics of diversity and inclusion, or any other protected status. Submit Interest
Industry Leader
Experience nursing excellence
Our Events
Meet a member of the Kaiser Permanente team at an upcoming career or professional event.