Nurse Case Manager: Care Continuum & Utilization Specialist

Kaiser Permanente; Santa Clara, Northern (CA, KY); Hybrid; USD 90,000 - 130,000; Full time

Job summary

Kaiser Permanente in Santa Clara, CA is seeking an experienced registered nurse in case management to coordinate patient care with physicians, staff, and outside providers.

The role involves developing treatment plans, monitoring clinical activities, and identifying cost‑effective care protocols. The position is subject to CNA bargaining unit review, with possible transfer options if applicable.

Qualifications

• Graduate of an accredited school of nursing.
• Bachelor's degree in nursing or health-related field, OR four years of experience in a directly related field.
• High School Diploma or GED required.
• Registered Nurse License (California).
• Knowledge of Nurse Practice Act and healthcare regulations.
• Ability to work in a Labor/Management Partnership environment.

Responsibilities

• Plans, develops, assesses, and evaluates care provided to members; develops and maintains case management policies and procedures; coordinates and performs reviews of care.
• Coordinates interdisciplinary approach to continuity of care, including utilization management and discharge planning.
• Consults with internal and external physicians and providers regarding continued care or hospitalization.
• Coordinates repatriation and monitors quality of care.
• Arranges follow-up appointments and encourages adherence to prescribed care.
• Identifies opportunities for cost savings and quality improvement across the continuum.
• Develops and collects data, and trends utilization of health care resources.
• Interprets regulations and plan benefits for members and providers.

Skills

Case management

Care coordination

Clinical assessment

Interdisciplinary collaboration

Utilization management

Education

BSN or higher

Licensed RN (CA)

HS diploma/GED

Job description

Kaiser Permanente in Santa Clara, CA is seeking an experienced registered nurse in case management to coordinate patient care with physicians, staff, and outside providers.

The role involves developing treatment plans, monitoring clinical activities, and identifying cost‑effective care protocols. The position is subject to CNA bargaining unit review, with possible transfer options if applicable.