Friday, September 23, 2022

Kaiser Jobs in Los Angeles

Case Manager

Job Details

Hiring Organization Kaiser Permanente Los Angeles Medical Center
Post Name Case Manager
Qualification Completion of an accredited RN training program that allows graduates to take the RN license exams.
Industry Private
Employment Type Full Time
Work Hours 8 Hours
Salary USD 17 To USD 20 Per Hour
Location Los AngelesCaliforniaUnited States 90027

Description:

Works collaboratively with an MD to coordinate and screen for the appropriateness of admissions and Continued stays. Makes recommendations to the physicians for alternate levels of care when the patient does not meet the medical necessity for Inpatient hospitalization.

Interacts with the family, patient, and other disciplines to coordinate a safe and acceptable discharge plan. Functions as an indirect caregiver, and patient advocate and manages patients in the most cost-effective way without compromising quality. Transfers stable non-members to planned Health care facilities.

Responsible for complying with AB 1203, Post Stabilization notification. Complies with other duties as described. Must be able to work collaboratively with the Multidisciplinary team, multitask, and in a fast pace environment.

Essential Functions:

  • Plans develop, assesses & evaluates care provided to members.
  • Collaborates with physicians, other members of the multidisciplinary health care team & patient/family in the development, implementation & documentation of appropriate, individualized plans of care to ensure continuity, quality & appropriate resource use.
  • Recommends alternative levels of care & ensures compliance with federal, state & local requirements.
  • Assesses high-risk patients in need of post-hospital care planning.
  • Develops & coordinates the implementation of a discharge plan to meet patients’ identified needs.
  • Communicates the plan to physicians, patients, family/caregivers, staff & appropriate community agencies.
  • Reviews, monitors, evaluates & coordinates the patient’s hospital stay to assure that all appropriate & essential services are delivered timely & efficiently.
  • Participates in the Bed Huddles & carries out recommendations congruent with the patient’s needs.
  • Coordinates the interdisciplinary approach to providing continuity of care, including Utilization Management, Transfer coordination, Discharge planning, & obtaining all authorizations/approvals as needed for outside services for patients/families.
  • Conducts daily clinical reviews for utilization/quality management activities based on guidelines/standards for patients in a variety of settings, including outpatient, emergency room, inpatient & non-KFH facilities.
  • Acts as a liaison between in-patient facility & referral facilities/agencies & provide case management to patients referred.
  • Refers patients to community resources to meet post-hospital needs.
  • Coordinates transfer of patients to appropriate facilities; maintains & provides required documentation.
  • Adheres to internal & external regulatory & accreditation requirements & compliance guidelines including but not limited to TJC, DHS, HCFA, CMS, DMHC, NCQA & DOL.
  • Educates members of the healthcare team concerning their roles & responsibilities in the discharge planning process & appropriate use of resources.
  • Provides patients with education to assist with their discharge & help them cope with psychological problems related to acute & chronic illness.
  • Per established protocols, reports any incidence of unusual occurrences related to quality, risk, and/or patient safety that is identified during case review or other activities.
  • Reviews, analyses & identifies utilization patterns & trends, problems or inappropriate utilization of resources & participates in the collection & analysis of data for special studies, projects, planning, or for routine utilization monitoring activities.
  • Coordinates participation & or facilitates care planning rounds & patient family conferences as needed.
  • Participates in committees, teams, or other work projects/duties as assigned.

Basic Qualifications:

  • Two (2) years of clinical experience as an RN in an acute care setting are required. Education
  • Completion of an accredited RN training program that allows graduates to take the RN license exams.
  • Licenses, Certifications, Registrations- Current California RN license required.- AHA BLS.

Additional Requirements:

  • Demonstrated ability to utilize/apply the general and specialized principles, practices, techniques, and methods of Utilization review/management, discharge planning, or case management.
  • Working knowledge of regulatory requirements and accreditation standards (TJC, Medicare, Medi-Cal, etc.).
  • Demonstrated ability to utilize written and verbal communication, interpersonal, critical thinking, and problem-solving skills.
  • Demonstrated ability in planning, organizing, conflict resolution, and negotiating skills.- Computer literacy skills are required.

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