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Care Coordinator, Inpatient 24/hr

Location Hillsboro, Oregon Job Number 1006256 Date posted 10/26/2021
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Inpatient Care Managers are Registered Nurses who collaborate with the primary clinician and the health care team to manage patients with discharge planning needs.  The Inpatient Care Manager performs an independent assessment of patient care needs and subsequently develops and implements a plan of care for the patient's transition from the acute care setting.  Inpatient Care Managers also serve as expert resource consultants and educators for the health care team members, assure the coordination of internal and community resources, support the evaluation and improvement of care systems to support the optimal utilization of resources and promotion of quality patient care.  The Inpatient Care Manager assumes primary accountability for the anticipation, assessment, and development, implementation, and communication of the discharge plan of care for patients with post-hospital care needs.

Essential Responsibilities:

  • Coordinates post-discharge patient care needs to assure the timely and effective discharge of routine and complex patients from the hospital setting.

  • Independently and proactively completes and documents patient assessments which are thorough, timely, age appropriate, and reflect psychosocial support systems, care needs, health plan benefits, level of care determinations for hospitalized patients.

  • Coordinates and communicates with patients, families, and the health care team to develop mutually agreeable plans of care that optimize the use of resources to support the particular needs of individual patients.

  • Facilitates resolution of issues which present barriers to safe transfers through the use of patient/team care conferences to assure the efficient transition to a lower level of care and to assure the patient/family receives the right care at the right time so that quality and utilization of resources are simultaneously enhanced.

  • Ensures systematic and ongoing contact with interdisciplinary staff and continuing care services to assure the safe transition of patients across care settings.
  • In collaboration with the interdisciplinary health care team, ensures regulatory and compliance standards are met. Perform duties as requested.

  • Basic Qualifications:


    • Minimum two (2) years of acute hospital experience with progressive levels of responsibility.

    • BSN or bachelor's degree in a health-care related field or currently enrolled in a BSN program, or four (4) years hospital case management experience.

    • High School Diploma or General Education Development (GED) required.
      License, Certification, Registration

    • Current Oregon and Washington RN license required. License in state where assigned required upon hire/transfer, application for license in secondary state required within 6 weeks of hire/transfer and must be obtained within 6 months.

    • Basic Life Support (BLS) for Health Care Providers required within 90 days of hire/transfer.

      Additional Requirements:

    • Demonstrated ability to interrelate with physicians, nurses, support staff, and patients in interdisciplinary approach.

    • Demonstrated ability to work as part of a team and work as a constant patient advocate.

    • Basic physical, psychosocial, functional assessment skills.

    • Familiar with care processes and systems in settings internal and external to Kaiser Permanente.

    • Familiar with and able to collaborate with Kaiser Permanente and community resources.

    • Thorough knowledge of principles of teaching and delegation, physical assessment and care planning, and appropriate utilization of acute hospital, long-term care, and home care resources.

    • Able to develop concise and thorough documentation of patient clinical assessment and care needs.

    • Highly effective problem solving, written and verbal communication, organizational and time management skills.

    • Familiarity with and ability to use computers.

      Preferred Qualifications:

    • Minimum two (2) years of Medical/Surgical, Critical Care, or NICU Nursing.

    • Minimum three (3) years of recent experience in one or more of the following areas:  Hospital Inpatient Discharge Planning, Community Health, Home Health and/or Utilization Management.

    • Certified Case Management (CCM) is preferred upon hire/transfer.

    • Knowledge of appropriate utilization of acute hospital and Kaiser Permanente internal resources.

    • Knowledge of Medicare and Medicaid regulations related to eligibility requirements: hospital, nursing facilities, home health, hospice, and Durable Medical Equipment (DME).

    • Demonstrated clinical judgment and customer-focused service skills.

    • Knowledge of principles of patient teaching, disease prevention measures, and physical assessment as it relates to the needs of patient and the next level of care.

    • Demonstrated ability to communicate and interact with physicians, nurses, patients and families.

    • Able to type 30 WPM with accuracy.

    • Master's degree


    • Mon-Sun (Variable)

    Primary Location: Oregon,Hillsboro,Westside Hospital Scheduled Weekly Hours: 24 Shift: Evening Workdays: Mon, Tue, Wed, Thu, Fri, Sat, Sun, Working Hours Start: 01:30 PM Working Hours End: 10:00 PM Job Schedule: Part-time Job Type: Standard Employee Status: Regular Employee Group/Union Affiliation: W05|AFT|Local 5017 Job Level: Individual Contributor Specialty: Quality Management Department: Westside Medical Cntr - UR-Discharge Planning - 1001 Travel: Yes, 10 % of the Time Kaiser Permanente is an equal opportunity employer committed to a diverse and inclusive workforce. Applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), age, sexual orientation, national origin, marital status, parental status, ancestry, disability, gender identity, veteran status, genetic information, other distinguishing characteristics of diversity and inclusion, or any other protected status.

    External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with federal and state laws, as well as applicable local ordinances, including but not limited to the San Francisco and Los Angeles Fair Chance Ordinances.