Discharge & Utilization Nurse Navigator

Kaiser Permanente; Atlanta (GA); Hybrid; USD 85,000 - 110,000; Full time

Job summary

Kaiser Permanente is seeking an experienced RN for utilization management and discharge planning to optimize care for hospitalized members. You will collaborate with physicians and care teams to ensure timely discharge planning and compliance with regulatory standards.

Responsibilities include daily inpatient reviews, admission assessments, and social work referrals, with an emphasis on patient safety, quality outcomes, and cross-functional teamwork within the health plan.

Qualifications

• Minimum two (2) years of RN experience in utilization/case management, discharge planning, quality improvement, or patient care delivery.
• Bachelor's Degree in Nursing or four (4) years of experience in a directly related field required.
• Experience in managed care environment and regulatory knowledge desirable.

Responsibilities

• Conduct daily inpatient utilization reviews (prospective, concurrent, retrospective).
• Perform admission utilization review on admission.
• Assess discharge planning needs and document within 24 hours; initiate discharge planning.
• Conduct daily bedside rounds and update discharge plans.
• Coordinate post-hospital care and ensure appropriate level of care.
• Communicate with hospitalists and care teams to address barriers to discharge.
• Prepare letters of non-coverage when criteria not met for inpatient care.
• Maintain HIPAA compliance and confidentiality.

Skills

RN experience

Education

Bachelor's Degree in Nursing

Job description

Kaiser Permanente is seeking an experienced RN for utilization management and discharge planning to optimize care for hospitalized members. You will collaborate with physicians and care teams to ensure timely discharge planning and compliance with regulatory standards.

Responsibilities include daily inpatient reviews, admission assessments, and social work referrals, with an emphasis on patient safety, quality outcomes, and cross-functional teamwork within the health plan.