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Case Management Utilization RN, 20/hr Day

Fontana, California

At 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: Part-time
  • Job Level: Individual Contributor
  • Travel: No

Success Profile

We’re looking for Nurse Leaders who possess the following traits.

  • Collaborative
  • Compassionate
  • Flexible
  • Leadership
  • Socially Conscientious
  • Trustworthy

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We offer several benefits to our nurses.

  • Medical, Vision & Dental

  • Retirement Plans

  • Educational Opportunities & Tuition Reimbursement

  • Supportive Teams & Resources

  • Career Growth & Development

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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.

Case Management Utilization RN, 20/hr Day

Primary Location Fontana, California Worker Location Onsite Facility Fontana Medical Center Job Number 1321434 Date posted 12/18/2024
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Description:
Job Summary:

Works collaboratively with an MD to coordinate and screen for the appropriateness of admissions and Continued stays. Makes recommendations to the physicians for alternate levels of care when the patient does not meet the medical necessity for Inpatient hospitalization. Interacts with the family, patient and other disciplines to coordinate a safe and acceptable discharge plan. Functions as an indirect caregiver, patient advocate and manages patients in the most cost effective way without compromising quality. Transfers stable non-members to planned Health care facilities. Responsible for complying with AB 1203, Post Stabilization notification. Complies with other duties as described. Must be able to work collaboratively with the Multidisciplinary team, multitask and in a fast pace environment.


Essential Responsibilities:

  • Plans, develops, assesses and evaluates care provided to members.
  • Collaborates with physicians, other members of the multidisciplinary health care team and patient/family in the development, implementation and documentation of appropriate, individualized plans of care to ensure continuity, quality and appropriate resource use.
  • Recommends alternative levels of care and ensures compliance with federal, state and local requirements.
  • Assesses high risk patients in need of post-hospital care planning.
  • Develops and coordinates the implementation of a discharge plan to meet patients identified needs.
  • Communicates the plan to physicians, patient, family/caregivers, staff and appropriate community agencies.
  • Reviews, monitors, evaluates and coordinates the patients hospital stay to assure that all appropriate and essential services are delivered timely and efficiently.
  • Participates in the Bed Huddles and carries out recommendations congruent with the patients needs.
  • Coordinates the interdisciplinary approach to providing continuity of care, including Utilization management, Transfer coordination, Discharge planning, and obtaining all authorizations/approvals as needed for outside services for patients/families.
  • Conducts daily clinical reviews for utilization/quality management activities based on guidelines/standards for patients in a variety of settings, including outpatient, emergency room, inpatient and non-KFH facilities.
  • Acts as a liaison between in-patient facility and referral facilities/agencies and provides case management to patients referred.
  • Refers patients to community resources to meet post hospital needs.
  • Coordinates transfer of patients to appropriate facilities; maintains and provides required documentation.
  • Adheres to internal and external regulatory and accreditation requirements and compliance guidelines including but not limited to: TJC, DHS, HCFA, CMS, DMHC, NCQA and DOL.
  • Educates members of the healthcare team concerning their roles and responsibilities in the discharge planning process and appropriate use of resources.
  • Provides patients with education to assist with their discharge and help them cope with psychological problems related to acute and chronic illness.
  • Per established protocols, reports any incidence of unusual occurrences related to quality, risk and/or patient safety which are identified during case review or other activities.
  • Reviews, analyses and identifies utilization patterns and trends, problems or inappropriate utilization of resources and participates in the collection and analysis of data for special studies, projects, planning, or for routine utilization monitoring activities.
  • Coordinates, participates and or facilitates care planning rounds and patient family conferences as needed.
  • Participates in committees, teams or other work projects/duties as assigned.
Basic Qualifications:

Experience


  • Two (2) years combined RN experience in an acute care setting or case management required.


Education


  • Completion of an accredited RN training program that allows graduates to take RN license exam.


License, Certification, Registration


  • Registered Nurse License (California)



  • Basic Life Support


Additional Requirements:


  • 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.


Preferred Qualifications:


  • Bachelors degree in nursing or healthcare related field.

  • Acute case management, hospital experience preferred. 



Notes:


This assignment is a UM Department CM In-patient position.


Primary Location: California,Fontana,Fontana Medical Center Scheduled Weekly Hours: 20 Shift: Day Workdays: Mon, Tue, Wed, Thu, Fri, Sat, Sun Working Hours Start: 08:30 AM Working Hours End: 05:00 PM Job Schedule: Part-time Job Type: Standard Worker Location: Onsite Employee Status: Regular Employee Group/Union Affiliation: B21|AFSCME|SCNSC Job Level: Individual Contributor Department: Fontana Medical Center - New - Utilization Management - 0801 Pay Range: $60.79 - $74.4 / hour Sign on bonus: $2000.00 The ranges posted above reflect the location in the job posting. The salary range may vary if you reside in a different location or state than the location posted. Travel: No On-site: Work location is on-site (KP designated office, medical office building or hospital). Worker location must align with Kaiser Permanente's Authorized States policy. At Kaiser Permanente, equity, inclusion and diversity are inextricably linked to our mission, and we aim to make it a part of everything we do. We know that having a diverse and inclusive workforce makes Kaiser Permanente a better place to receive health care, a more supportive partner in our communities we serve, and a more fulfilling place to work. Working at Kaiser Permanente means that you agree to and abide by our commitment to equity and our expectation that we all work together to create an inclusive work environment focused on a sense of belonging and wellbeing.

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.

For jobs where work will be performed in unincorporated LA County, the employer provides the following statement in accordance with the Los Angeles County Fair Chance Ordinance. Criminal history may have a direct, adverse, and negative relationship on the following job duties, potentially resulting in the withdrawal of the conditional offer of employment:

  • Consistently supports compliance and the Principles of Responsibility (Kaiser Permanente's Code of Conduct) by maintaining the privacy and confidentiality of information, protecting the assets of the organization, acting with ethics and integrity, reporting non-compliance, and adhering to applicable federal, state, and local laws and regulations, accreditation, and licensure requirements (where applicable), and Kaiser Permanente's policies and procedures.

  • Models and reinforces ethical behavior in self and others in accordance with the Principles of Responsibility, adheres to organizational policies and guidelines; supports compliance initiatives; maintains confidences; admits mistakes; conducts business with honesty, shows consistency in words and actions; follows through on commitments.

  • Job duties with at least occasional or possible access to: (1) patients, the general public, or other employees; (2) confidential protected health information and other confidential KP information (including employee, proprietary, financial or trade secret information); (3) KP property and assets, for example, electronic assets, medical instruments, or devices; (4) controlled substances regulated by federal law or potentially subject to diversion.
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