JOB DETAILS
Coordinates with physicians, staff and non-Kaiser providers and facilities regarding patients transitions and discharge planning. In conjunction with physicians, develops plans of care and discharge plans, and makes recommendations for alternative levels of care as required.
Essential Responsibilities:
Utilization Management: Performs daily pre-admission, admission, and concurrent utilization reviews using guidelines, institutional policies/procedures, and other information to determine appropriate levels of care and readiness for discharge.
Monitors the progression of the discharge plan and facilitates discussions with the multidisciplinary teams.
Educates other healthcare team members on utilization and care coordination.
Collaborates with and provides information to patients, families, physicians, and staff regarding the discharge plans and transitions.
Understands and consistently applies the interpretation, and utilization of member health care benefits.
Conducts UM, care coordination and discharge planning activities according to all applicable regulatory requirements.
Discharge Planning: Ensures continuity of care through communication in rounds and written documentation, level of care recommendations, transfer coordination, discharge planning and obtaining authorizations/approvals as needed for outside services for the patient.
Develops, evaluates, and coordinates a comprehensive discharge plan in conjunction with the patient/family, physician, nursing, social services, and other health care providers and agencies.
Regulatory: Conducts UM, care coordination, and discharge planning activities according to all applicable regulatory requirements.
Kaiser Permanente conducts compensation reviews of positions on a routine basis. At any time, Kaiser Permanente reserves the right to reevaluate and change job descriptions, or to change such positions from salaried to hourly pay status. Such changes are generally implemented only after notice is given to affected employees.
REQUIREMENTS
Basic Qualifications:
Musthave previous Kaiser expereince
Experience
Minimum four (4) years of experience in hospital patient care delivery, OR completion of Masters degree in case management program in lieu of minimum years of experience.
Education
Graduate of accredited school of nursing.
Diploma/Associate Degree Nursing.
License, Certification, Registration
Registered Nurse License (California)
Basic Life Support
Additional Requirements:
Knowledge of the Nurse Practice Act, TJC, DMHC, CMS, NCQA, HIPPA, ERISA, EMTALA & all other applicable federal/state/local laws & regulations.
Demonstrated strong communication and customer service skills, problem-solving, critical thinking, & clinical judgment abilities.
Fundamental word processing & computer navigation skills & the ability to interpret & use analytic data in day to day operations.
Knowledge of health care benefits associated with various business line (Medicare/KPSA, Commercial/KFH, Medi-Cal, Federal, etc.).
Must be able to work in a Labor/Management Partnership environment.
PREFERRED REQUIREMENTS
Preferred Qualifications:
Minimum two (2) years of experience in utilization review, case management, and discharge planning preferred.
Bachelors degree in nursing or a health care related field preferred.
Masters degree in case management preferred.
BENEFITS
At AMN Healthcare we take care of our travelers! We offer:
- Competitive pay rates
- Free, quality, private housing
- Medical, Dental, Vision
- 401(k) and Flex Spending
- Life Insurance
- Accident and Short-term Disability Coverage
- Free Continuing Education
- Refer a friend and earn extra cash!
FACILITY
Short Term Acute Care Hospital
AREA OVERVIEW
Welcome to Roseville, CA - a lively city with endless opportunities for adventure and exploration. From hiking through the stunning Sierra Nevada Mountains to exploring the local wineries, there is never a dull moment in Roseville. Discover hidden gems in the charming downtown area, or spend a day soaking up the sun at Folsom Lake. With its vibrant arts scene, delicious dining options, and friendly locals, Roseville is the perfect place for a traveling healthcare professional to call home.
- Explore the beautiful trails at Miner's Ravine Trail Loop
- Taste local wines at the award-winning Wise Villa Winery
- Shop 'til you drop at the Westfield Galleria at Roseville
- Visit the Maidu Museum & Historic Site to learn about the area's indigenous history
- Enjoy a relaxing picnic at Royer Park
ABOUT THE COMPANY
At AMN Healthcare, we strive to be recognized as the most trusted, innovative, and influential force in helping healthcare organizations provide quality patient care that continually evolves to make healthcare more human, more effective, and more achievable.
* Estimate of weekly payments is intended for informational purposes and includes hourly wages, as well as reimbursements for meal & incidental expenses and housing expenses incurred on behalf of the Company. Please speak with a recruiter for additional details.
Qualified Applicants with arrest or conviction records will be considered for Employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.