Care Coordination Utilization Agent

Kaiser Permanente; Honolulu (HI); On-site; USD 42,000 - 64,000; Full time

Job summary

KAISER is seeking a Care Coordination Utilization Agent to manage hospital bed assignments at Moanalua Medical Center and to support the repatriation of Kaiser Health Plan members. The role includes handling inbound calls, collecting patient information, and triaging to the appropriate provider, while ensuring accurate documentation in the electronic medical record.

The candidate will collaborate with ER staff and House Supervisor to optimize patient throughput and coordinate transport as

Qualifications

• High school diploma or GED required.
• Experience applying analytic techniques and computer skills to hospital data.
• Strong analytic and verbal skills.
• Expertise with tracking, spreadsheets and graphic computer systems operating on PC mainframes.
• Knowledge of health plan benefits.
• Understanding of medical center operations and regional policies.

Responsibilities

• Maintain bed tracker for Moanalua Medical Center.
• Collaborate with House Supervisor and ER for bed placement and patient throughput.
• Assign beds for inpatient admissions at Moanalua Hospital.
• Coordinate repatriation of Kaiser Health Plan members with non-Kaiser facilities.
• Assist with coordination of Air & Ground Transportation.
• Enter referrals in Tapestry for Kaiser Health Plan members in non-Kaiser facilities.
• Provide timely response to incoming calls and triage to appropriate provider.
• Collect patient demographics, eligibility and reason for call; document in EMR.
• Assist with data entry in EMR and data management systems.
• Coordinate with members services to answer inquiries about benefits and charges.

Skills

Analytic techniques

Verbal skills

Data tracking

Spreadsheets

Graphic computer systems

PC mainframes

Health plan benefits

Medical center operations

Education

High School Diploma or GED

Associate/Bachelor's degree preferred

Tools

Tapestry

Electronic Medical Record (EMR)

Job description

Job Summary:

Responsible for hospital bed management at Moanalua Medical Center, including assistance with outside ED and hospital coordination for the repatriation of Kaiser Health Plan members, air and ground transportation, messaging and other duties, as necessary. Also, responsible for providing timely response to all inbound phone calls for the Care Coordination Center (CCC), including receiving initial patient information and demographics, eligibility information, request for service, and triaging calls to the appropriate provider (CCC Medic, RN or Physician). Documentation of member/ patient information into computerized data management systems and in manually maintained data files. Answers inquiries and educates member/ patient, physicians and hospitals, as necessary. Collaborates with the House Supervisor and Emergency Room team to ensure appropriate and timely patient hospital throughput.

Essential Responsibilities:

• Maintains bed tracker for Moanalua Medical Center.

• Collaborates with House Supervisor, Emergency Room, etc. for bed placement and patient throughput.

• Assigns beds at Moanalua Hospital for patients requiring an inpatient admission.

• Outreach to non-Kaiser Permanente hospitals for coordination and repatriation of Kaiser Health Plan members.

• Assist with coordination of Air & Ground Transportation.

• Assist with referral entry in Tapestry for Kaiser Health Plan members admitted to non-Kaiser Permanente facilities.

• Provides timely response to incoming calls and triages calls to appropriate provider.

• Initiates data collection from incoming call, to include: patient information and demographics, eligibility, and reason for call. May also document in the Kaiser Permanente electronic medical record.

• Assists with data entry in electronic medical record, computerized data management systems, and manually maintained data files.

• Collaboration with other services, e.g. membership services, to answer inquiries and educate patients, physicians and hospitals on covered benefits and charges.

Basic Qualifications:

Experience

• Minimum six (6) months of administrative experience in a health care facility or related experience.

Education

• High School Diploma or General Education Development (GED) required.

License, Certification, Registration

• N/A

Additional Requirements:

• Experience applying analytic techniques and computer skills to hospital data.

• Strong analytic and verbal skills.

• Expertise with tracking, spreadsheets and graphic computer systems operating on PC mainframes.

• Knowledge of health plan benefits.

• Understanding of medical center operations, complex health systems, with the ability to quickly grasp regional policies, contract interpretation of out-of-plan medical services. Must be able to work in a Labor/Management Partnership environment.

Preferred Qualifications:

• Associate of Arts or Bachelors degree preferred.

COMPANY: KAISER

TITLE: Care Coordination Utilization Agent

LOCATION: Honolulu, Hawaii

REQNUMBER: 1453606

External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran, or disability status.