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Regional Telephonic Case Manager RN
•30 days ago
| Hours | Full-time, Part-time |
|---|---|
| Location | Oakland, CA Oakland, California |
About this job
Coordinates w/physicians, staff, facilities, non-Kaiser providers, insurers, 3rd party administrators, & employers regarding patient care. In conjunction w/physicians, develops treatment plan, monitors all clinical activities, makes recommendations for alternative levels of care, identifies cost effective protocols, & develops guidelines for care..
Essential Responsibilities:
Guides, facilitates & expedites the care & maximum recovery for employees with work related illnesses or injuries through telephone and electronic communication with patients, carriers, employers, providers (internal & external), & Kaiser Permanente staff. Coordinates patient education & monitors & evaluates the options & services necessary to meet the individual patient's needs.Facilitates and assists physicians and disability case managers in return to work duties.Coordinates the interdisciplinary approach to providing continuity of care, including utilization management, transfer coordination, discharge planning, & facilitates authorizations and approvals as needed for outside services for patients/families.Educates & informs patient & family regarding treatment plan & facilitates return to wellness. Evaluates variance from treatment guidelines caused and takes remedial actions. Encourages member to follow prescribed course of care (e.g., drug therapy, physical therapy). Makes referrals to appropriate community services.Identifies & recommends opportunities for cost savings & improving the quality of care across the continuum.Develops & collects data, & trends relating to utilization of health care resources. Interprets regulations, health plan benefits, policies, & procedures for members, physicians, medical office staff,contract providers, and outside agencies.Coordinates transmission of clinical & benefit treatment to patients, families & outside agencies. Acts as liaison for outside agencies, nonplan facilities, & outside providers.Coordinates repatriation of patients & monitors their quality of care.
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.
Basic Qualifications:
Experience
Minimum of two (2) years working within an occupational health/industrial environment.Minimum of four (4) years of ongoing experience evaluating patients & work processes from a variety of industries.
Education
Bachelor's degree in nursing or health related field, OR four (4) years of experience in a directly related field.High School Diploma or General Education Development (GED) required.
License, Certification, Registration
Current RN license.
Additional Requirements:
Certified Occupational Health Nurse or Certified Case Manager certification required (or fulfilled within two (2) years of hire).Knowledge of current California Workers Compensation system & laws.Demonstrated experience in utilization management, return to work planning &/or case management.Knowledge of Nurse Practice Act.Must be able to work in a Labor/Management Partnership environment.
Preferred Qualifications:
Previous case management experience preferred.Master's degree preferred.
Essential Responsibilities:
Guides, facilitates & expedites the care & maximum recovery for employees with work related illnesses or injuries through telephone and electronic communication with patients, carriers, employers, providers (internal & external), & Kaiser Permanente staff. Coordinates patient education & monitors & evaluates the options & services necessary to meet the individual patient's needs.Facilitates and assists physicians and disability case managers in return to work duties.Coordinates the interdisciplinary approach to providing continuity of care, including utilization management, transfer coordination, discharge planning, & facilitates authorizations and approvals as needed for outside services for patients/families.Educates & informs patient & family regarding treatment plan & facilitates return to wellness. Evaluates variance from treatment guidelines caused and takes remedial actions. Encourages member to follow prescribed course of care (e.g., drug therapy, physical therapy). Makes referrals to appropriate community services.Identifies & recommends opportunities for cost savings & improving the quality of care across the continuum.Develops & collects data, & trends relating to utilization of health care resources. Interprets regulations, health plan benefits, policies, & procedures for members, physicians, medical office staff,contract providers, and outside agencies.Coordinates transmission of clinical & benefit treatment to patients, families & outside agencies. Acts as liaison for outside agencies, nonplan facilities, & outside providers.Coordinates repatriation of patients & monitors their quality of care.
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.
Basic Qualifications:
Experience
Minimum of two (2) years working within an occupational health/industrial environment.Minimum of four (4) years of ongoing experience evaluating patients & work processes from a variety of industries.
Education
Bachelor's degree in nursing or health related field, OR four (4) years of experience in a directly related field.High School Diploma or General Education Development (GED) required.
License, Certification, Registration
Current RN license.
Additional Requirements:
Certified Occupational Health Nurse or Certified Case Manager certification required (or fulfilled within two (2) years of hire).Knowledge of current California Workers Compensation system & laws.Demonstrated experience in utilization management, return to work planning &/or case management.Knowledge of Nurse Practice Act.Must be able to work in a Labor/Management Partnership environment.
Preferred Qualifications:
Previous case management experience preferred.Master's degree preferred.
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