Reg Mgr RN Care Coord & Case Mgt-MediCal
Pasadena, CaliforniaOur nurse leaders maintain a strong commitment to the highest standards of professional nursing practice and to sustain a culture of excellence. You will encourage your teams to use evidence-based practice to deliver high-quality patient care, contribute to research, and spread innovation beyond Kaiser Permanente. Backed by the resources of one of the nation’s largest health care providers, you’ll motivate and inspire your team to achieve goals, value individual contributions, and celebrate accomplishments in meaningful ways while realizing your own potential as a leader.
- Job Type: Full-time
- Job Level: Manager with Direct Reports
- Travel: No
Success Profile
We’re looking for Nurse Leaders who possess the following traits.
- Adaptable
- Collaborative
- Compassionate
- Leadership
- Problem-Solver
- Results-Oriented
Benefits
Our compensation and benefits are designed to help you and your family stay healthy and thrive.
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Medical, Vision & Dental
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Retirement Plans
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Tuition Reimbursement
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Tuition Reimbursement
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Supportive Team & Resources
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Career Growth & Development
Our Culture
Our Nurse Leaders cultivate an environment of compassion, integrity, trust, and open communication that helps our teams do their best work. Together, we pursue lifelong learning in the belief that it expands our knowledge so we can better serve our patients. We participate in research to inform our evidence-based care. Our nurses reflect the rich diversity of our members and communities, and provide culturally responsive and competent care that promotes the understanding of our members’ needs and preferences. At Kaiser Permanente, nurses are highly skilled professionals who exemplify leadership, critical thinking, and collaborative problem-solving, and deliver the right care, at the right time, in the right setting.
What Our People Are Saying
Ghada, PhD, RN, NEA-BC, CENP
SCAL Regional Director
Patient Care Services
“So proud to be a Kaiser Permanente nurse leader. Despite all the challenges we experienced with the pandemic, we remained true to our mission to provide safe, quality care to our patients and members, and continue to encourage our employees to grow and develop professionally. I have completed my Doctor of Philosophy in Nursing and lead with an exceptional team. There are boundless opportunities here.”
Gertrude, RN, BSN, MSA
Administrative Service Director
Nursing Administration
“Kaiser Permanente has a mission of providing affordable health care not just for our members, but also the community — which is a passion of mine. I consider myself very fortunate to work for an organization that values their employees. As a nurse leader, I LOVE what I do! We provide endless possibilities for growth and professional development.”
Michele, JD, MBA, RN
Director
Nursing Professional Development and
Simulation/Magnet Journey
“Kaiser Permanente provides its nurse leaders with opportunities to innovate and thrive in an evidence-based practice that’s advancing the science of nursing and embracing a culture of excellence.”
Philidah, MSN, RN
Sr. Director of Nursing
“It’s a privilege to work for Kaiser Permanente. They support nurses through a variety of learning opportunities, from self-paced learning to leadership courses and stretch assignments. It enables equitable opportunities for professional growth and career advancement.”
Mervin
Assistant Medical Center Administrator
“I’m incredibly grateful for the support I received from Kaiser Permanente. I would not be where I am right now without the mentoring from outstanding leaders, the strong relationships I built with my team, and the partnership with other departments.”
Melissa
Assistant Nurse Manager
“I’m in my first position here, but I’ve already had the opportunity to be part of the Magnet Journey, quality and safety committees, and co-chair Professional Nursing Excellence Council. Kaiser Permanente continues to help me grow through leadership training programs like Activate and stretch assignments.”
Aletha
Department Manager
“Kaiser Permanente has many resources and tools to help us grow professionally. We have courses and financial aid for individuals who choose to advance.I love being a leader because I love to encourage, inspire, and develop my team. I also embrace challenges and enjoy collaborating in projects that positively impact our members.”
Adriana
Department Manager RN
“Kaiser Permanente allows me to focus on preventive health care, which contrasts with my acute care background. I appreciate the preventive care services that we offer our members and the different forms of communication based on personal preference.”
Reg Mgr RN Care Coord & Case Mgt-MediCal
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Essential Responsibilities:
- Manages the day-to-day operations of the Regional Care Coordination / Case Management department and team members. Partners with team leads to drive day to day operations.
- Provides operations oversight of care coordination, case management, and care transition functions.
- Collaborates with internal and external physicians, health care providers, discharge planners, other care managers and outside agencies to ensure that continued care/treatment or hospitalization or referral to support services or placement is available to program members.
- Ensures that all operational program activities follow the KP benefits, policy, and with the various regulatory agencies involved with the management and monitoring of medical care and reimbursement and with government legislative directives.
- Provides oversight on strategies set by case managers to target/assess risk factors and achieve and ensure patient follow up according to clinical and strategic measures/outcomes.
- Ensures adherence to case management policies and procedures.
- Ensures appropriate development and implementation of case management plans. Ensures that case managers are developing individualized patient/family education plans focused on self-care management.
- Ensures that case managers coordinate care/services with utilization and/or quality reviewers and monitors level and quality of care.
- Manages the administrative functions of the Care Coordination and Case Management operations, including space planning/management, identification/proposals for system development/enhancements, recruiting, hiring, training, discipline/reward and termination of Care Coordination/Case Management department staff.
- Monitors, reviews, analyzes, and maintains accurate data as it relates to outcomes, effectiveness of case management plans, and trends. Oversees the participation by case managers with healthcare team/providers in actualizing outcomes by planning, evaluating, and implementing decisions and strategies to achieve predetermined cost, clinical, quality, utilization, and service outcomes.
- Participates and prepares regulatory audits.
- Trains case managers on the interdisciplinary approach to providing continuity of care, including utilization management, transfer coordination, discharge planning, and obtaining all authorizations/approvals/transfers as needed for outside services for patients/families.
- Works closely with groups across the continuum, including but not limited to Inpatient Case Management, Long Term Care/Skilled Nursing, medical group operations, Quality, Chiefs Groups, to share information and solicit feedback.
- Liaisons with other functional groups, including but not limited to, UM Directors, PCM Leaders, Assistant Administrators, Continuing Care, Social Medicine, Long Term Care, Palliative Care, Home Health/ Hospice, to share information and solicit feedback Prepares written and verbal reports on program status, outcome metrics and other deliverables to designated regional and local senior leaders, committees and groups.
- Tracks program and case manager productivity and creates performance plan if needed. Serves as clinical resource for escalation questions or concerns by case managers & pharmacists. Creates monthly productivity for each program and develops action plan for areas with low performance.
- Performs other duties as assigned.
- #RNMGR
- Minimum three (3) years of supervisory/management experience required.
- Bachelors degree in nursing, health administration or public health required.
- Graduate of an accredited school of nursing.
- Registered Nurse License (California)
- Knowledge and expertise in case management scope of practice, technique and community resources.
- Strong conformability with KPHC and the implementation of new modules within KPHC
- Demonstrated knowledge of case management, discharge planning, transition of care, transfer coordination; Medicare, Medicaid, Title 22, NCQA, JCAHO, URAC, and other federal/state/local regulations.
- Skilled collaborator and team builder.
- Ability in planning, organizing, conflict resolution, negotiating and interpersonal skills.
- Knowledge regarding compliance requirements by the various regulatory agencies and various legislative directives affecting health care management and reimbursement.
- Excellent communication skills, good problem-solving skills, and decision-making skills; PC skills to include Microsoft word, excel, power point, and electronic medical record.
- Strong customer service orientation required.
- Must be able to work in a Labor/Management Partnership environment.
- Minimum five (5) years of case management, or care management experience preferred.
- Extensive program development and program management experience in health care provider/payer setting preferred.
- Masters degree in nursing or related healthcare field preferred.
- Certification as a case manager preferred with experience in home health, discharge planning, utilization management, and/or ambulatory case management desired.
Notes:
• Occasional weekends.
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. Submit Interest
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