Hospital Care Coordination & Discharge Planner

Kaiser Permanente; Wailuku (HI); On-site; USD 90,000 - 110,000; Full time

Job summary

Kaiser Permanente in Wailuku, Hawaii seeks a Hospital Case Manager to coordinate with physicians, staff, and facilities regarding patient care. You will develop plans of care and discharge plans, monitor clinical activities, and advise on appropriate levels of care under Medicare regulations.

The role requires an RN license in Hawaii, four years of acute or sub-acute inpatient experience, and care management or internship experience.

Qualifications

• Four years of acute or sub-acute inpatient care experience.
• One year of Care Management experience or completion of the MHS Case Management Internship within 6 months of hire.
• Bachelor's degree in nursing or four years of directly related experience.

Responsibilities

• Performs daily pre-admission, admission, and concurrent utilization reviews to determine appropriate levels of care and readiness for discharge.
• Escalates utilization and system problems which have not been resolved immediately. Performs rounds and reviews patient admissions under Kaiser SNF benefit.
• Utilizes knowledge of Medicare regulations and Health Plan benefits to determine medical necessity. Monitors plan of care and facilitates discussions with multidisciplinary teams.
• Educates other healthcare team members on utilization and cost containment initiatives. Collaborates with patients, families, physicians, and staff regarding provisions of care.
• Issues denial/notices of non-coverage letters after conferring with physicians.
• Ensures continuity of care for outside services for the patient. Monitors level of care and coordinates comprehensive discharge plans.
• Monitors care processes and participates in guideline development for patient care. Identifies opportunities for cost-savings and quality improvements.
• Keeps abreast of changes in health care benefits, laws, or regulatory requirements influencing health plan benefits.

Skills

Word processing

Spreadsheet

Database PC applications

Education

Bachelor's degree in nursing

Job description

Kaiser Permanente in Wailuku, Hawaii seeks a Hospital Case Manager to coordinate with physicians, staff, and facilities regarding patient care. You will develop plans of care and discharge plans, monitor clinical activities, and advise on appropriate levels of care under Medicare regulations.

The role requires an RN license in Hawaii, four years of acute or sub-acute inpatient experience, and care management or internship experience.