Case Management Utilization RN-Per Diem Day
Fontana, CaliforniaAt 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: Per Diem
- 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
Benefits
We offer several benefits to our nurses.
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Medical, Vision & Dental
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Retirement Plans
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Educational Opportunities & Tuition Reimbursement
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Supportive Teams & Resources
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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
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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.”
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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.”
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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.”.
![](https://tbcdn.talentbrew.com/company/641/v3_0/img/ajd/rn-ajd/kpnw-caitlin-low.jpg)
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.”
![](https://tbcdn.talentbrew.com/company/641/v3_0/img/ajd/rn-ajd/kimberly-gomez-picture.jpg)
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.”
![](https://tbcdn.talentbrew.com/company/641/v3_0/img/ajd/rn-ajd/david-saqueton.png)
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.”
![](https://tbcdn.talentbrew.com/company/641/v3_0/img/ajd/rn-ajd/shawn-hornbuckle-headshot.png)
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-Per Diem Day
Navigating the Hiring Process
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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.
- 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.
- Two (2) years combined RN experience in an acute care setting or case management required.
- Completion of an accredited RN training program that allows graduates to take RN license exam.
- Registered Nurse License (California)
- Basic Life Support
- 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.
- Bachelors degree in nursing or healthcare related field.
- ACUTE CASE MANAGEMENT, HOSPITAL EXPERIENCE PREFERRED.
Notes:
- every other weekend
- THIS ASSIGNMENT IS A UM DEPARTMENT CM IN-PATIENT POSITION
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
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