Continuing Care Coordinator RN needed in Modesto!
This position supports Kaiser Permanente�s code of conduct and compliance by adhering to all laws and regulations, accreditation and Licensure requirements, and internal policies and procedures. Kaiser Permanente is proud to be an equal opportunity/affirmative action employer.DEPARTMENT: Continuing Care Dept.SCHEDULE: Full-Time Regular, 40hrs/wk, Day shift, Monday-Friday, 8:00am to 5:00pm.EDUCATION/ LICENSE/CERTIFICATION: -Bachelors degree, or equivalent experience, in nursing or health related field highly preferred. -Masters degree preferred. -Previous experience in an inpatient setting (usually 2 years). -Graduate of accredited school of nursing. -Current California RN license.SKILLS TESTING: N/AQUALIFICATIONS: -Clinical expert in area of review preferred.POSITION SUMMARY: -Coordinates review of in-house patients and those members at contracted facilities. -Assists in the discharge planning processDUTIES: -Conducts clinical reviews based on established treatment criteria for members admitted to contracted facilities. -Reviews utilization patterns, identifies trends and problems areas for special studies. -Assists other health care providers in the discharge planning process and triaging on alternative unit of care. -Assists in collecting and assimilating clinical data to enhance the quality of services. -Generates quality improvement results. -Collaborates with physicians on plans clinical reviews, keeps them appraised of Kaiser clinical criteria. -Reports and investigates unusual occurrences and questions inappropriate decisions based on their professional expertise. -Interviews patients/caregivers regarding care after hospitalization. -Counsels on Medicare and health care plan coverage. -Coordinates referrals to appropriate agencies/facilities. 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. Consistently supports compliance and the Principles of Responsibility (KP�s code of conduct) by maintaining confidentiality, protecting the assets of the organization, acting with ethics and integrity, reporting non-compliance, and adhering to applicable Federal and State laws and regulations, accreditation and licensure requirements, and KP policies and procedures.In addition to defined technical requirements, accountable for consistently demonstrating service behaviors and principles defined by the Kaiser Permanente Service Quality Credo, the KP Mission as well as specific departmental/organizational initiatives. Also accountable for consistently demonstrating the knowledge, skills, abilities, and behaviors necessary to provide superior and culturally sensitive service to each other, to our members, and to purchasers, contracted providers and vendors.