Coordinator Patient Care-Case Management Call-In
Not Disclosed•Full-TimeOn-site
location_onWaiawa Prison Road, Waipahu, Honolulu County, Hawaii, 96789, United States
About the Role
This position serves as a vital bridge between Kaiser Permanente, physicians, and external providers to ensure seamless patient care. You will collaborate closely with clinical teams to develop comprehensive plans of care and discharge strategies, while simultaneously monitoring clinical activities to identify cost-effective protocols. The role is designed to uphold the highest standards of medical necessity and continuity of care, ensuring that patients receive appropriate levels of treatment throughout their journey.
In this capacity, you will conduct daily pre-admission, admission, and concurrent utilization reviews, utilizing your knowledge of Medicare regulations and health plan benefits to determine the right care pathways. You will facilitate multidisciplinary discussions, educate team members on cost containment initiatives, and issue necessary notices of non-coverage after consulting with physicians. Beyond administrative oversight, the role involves direct patient care on an as-needed basis to maintain clinical expertise and competency, ensuring that your practice aligns with the KP Nursing Vision, Model, and Values.
Work location
Work model: On-site
Waiawa Prison Road, Waipahu, Honolulu County, Hawaii, 96789, United States
Waipahu, Hawaii
Key Responsibilities
- check_circleCoordinate with physicians and staff regarding patient care and discharge planning
- check_circlePerform daily pre-admission, admission, and concurrent utilization reviews
- check_circleDevelop and evaluate comprehensive discharge plans with multidisciplinary teams
- check_circleMonitor care processes and implement cost-savings and quality improvement initiatives
- check_circleIssue denial and non-coverage letters after conferring with physicians
- check_circleEnsure continuity of care for outside services and monitor levels of care
- check_circleProvide direct patient care to maintain clinical expertise and competency
Requirements
- verifiedMinimum 2 years experience in utilization review, case management, transitional care, discharge planning, or acute care nursing
- verifiedBachelor's degree in nursing or related health care field OR 4 years directly related acute care nursing hospital experience
- verifiedHigh School Diploma or GED required
- verifiedRegistered Nurse License (Hawaii)
- verifiedBasic Life Support from American Heart Association
- verifiedDemonstrated knowledge of word processing, spreadsheet, and database PC applications
- verifiedDemonstrated knowledge of CMS guidelines, Medicare and Medicaid rules and regulations
- verifiedMasters Degree in health care administration, nursing, or related field
- verifiedPreferred Case Manager (CCMA, ACMA, or ANCC)
Nice to Have
Demonstrated knowledge and understanding of CMS guidelines, Medicare and Medicaid rules and regulations. Community health, home health or skilled nursing care experience. Masters Degree in health care administration, nursing, or related field. Preferred Case Manager (CCMA, ACMA, or ANCC).
Similar Job Opportunities
Skills, education and keywords
Skills: Utilization Review, Case Management, Transitional Care, Discharge Planning, Med/surg, Telemetry, Icu, Emergency Room, Orthopedics, Word Processing.
Education: Bachelor's degree in nursing or related field, or 4 years of acute care nursing experience; High School Diploma or GED required; Masters Degree in health care administration, nursing, or related field preferred.
Frequently asked questions about Coordinator Patient Care-Case Management Call-In at Kaiser Permanente
What does a Coordinator Patient Care-Case Management Call-In at Kaiser Permanente do?expand_more
In this Coordinator Patient Care-Case Management Call-In at Kaiser Permanente role, you will coordinate with physicians and staff regarding patient care and discharge planning; perform daily pre-admission, admission, and concurrent utilization reviews; develop and evaluate comprehensive discharge plans with multidisciplinary teams; and monitor care processes and implement cost-savings and quality improvement initiatives.
What are the requirements for this Coordinator Patient Care-Case Management Call-In role?expand_more
To qualify for the Coordinator Patient Care-Case Management Call-In at Kaiser Permanente position, applicants should have: Minimum 2 years experience in utilization review, case management, transitional care, discharge planning, or acute care nursing; Bachelor's degree in nursing or related health care field OR 4 years directly related acute care nursing hospital experience; High School Diploma or GED required; Registered Nurse License (Hawaii); Basic Life Support from American Heart Association; and Demonstrated knowledge of word processing, spreadsheet, and database PC applications.
Where is the Coordinator Patient Care-Case Management Call-In role at Kaiser Permanente located?expand_more
Coordinator Patient Care-Case Management Call-In at Kaiser Permanente is based in Waiawa Prison Road, Waipahu, Honolulu County, Hawaii, 96789, United States. This is a on-site role.
Is this Coordinator Patient Care-Case Management Call-In job remote, hybrid, or on-site?expand_more
Kaiser Permanente has listed this Coordinator Patient Care-Case Management Call-In role as on-site.
How much experience is required for this Coordinator Patient Care-Case Management Call-In role?expand_more
Coordinator Patient Care-Case Management Call-In at Kaiser Permanente typically requires 2+ years of relevant experience at the mid level level.
What skills do you need for the Coordinator Patient Care-Case Management Call-In role at Kaiser Permanente?expand_more
Key skills for Coordinator Patient Care-Case Management Call-In at Kaiser Permanente include Utilization Review; Case Management; Transitional Care; Discharge Planning; Med/surg; Telemetry; Icu; and Emergency Room.
What education is required for Coordinator Patient Care-Case Management Call-In at Kaiser Permanente?expand_more
Educational requirements for this role: Bachelor's degree in nursing or related field, or 4 years of acute care nursing experience; High School Diploma or GED required; and Masters Degree in health care administration, nursing, or related field preferred.
What category does the Coordinator Patient Care-Case Management Call-In role belong to?expand_more
Coordinator Patient Care-Case Management Call-In at Kaiser Permanente is part of the Healthcare & Nursing job category on Recrutus.
About Kaiser Permanente
Kaiser Permanente Anaheim Medical Center is part of Kaiser Permanente, a not-for-profit integrated health care organization headquartered in Oakland, California. The system includes 39 hospitals and more than 734 care locations across eight states and the District of Columbia, serving over 12.7 million individuals. The organization focuses on delivering coordinated, patient-centered health services through multidisciplinary teams committed to improving health outcomes. Kaiser Permanente prioritizes fostering inclusive work environments, supporting professional development, and expanding access to care through community-focused initiatives. For job seekers, the network offers roles in clinical, administrative, and technical fields, emphasizing collaboration and innovation in the health care industry.
Browse more roles: All Kaiser Permanente jobs, Healthcare & Nursing jobs on Recrutus.