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RN Coordinator, UM/Home Health (FT, Days)
At Kaiser Permanente our nurses are leaders, clinicians, researchers, innovators, and scientists who are contributing toward being an industry-leading voice for advancing evidence-based care. Whether supporting the patient directly in our hospitals or clinics, providing care at home, serving our patients through innovative virtual technology, or managing care delivery teams, Kaiser Permanente nurses utilize scientific evidence and our integrated care model to optimize the total health of our members and the communities we serve. We invite nurses who are passionate about nursing excellence, high-quality compassionate care delivery, professionalism, integrity, teamwork and patient and family centeredness to join our teams so that we can continue to sustain and build upon our culture of excellence.
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Job Schedule: Full-time
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Scheduled Weekly Hours:
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Shift: Day
Success Profile
We’re looking for Nurse Leaders who possess the following traits.
- Collaborative
- Compassionate
- Flexible
- Leadership
- Socially Conscientious
- Trustworthy
Benefits
We offer several benefits to our nurses.
Our Culture
At Kaiser Permanente, we cultivate an environment of compassion, integrity, trust, and open communication that helps our teams do their best work. We believe that lifelong learning will expand our knowledge so we can better serve our patients. Our practice is rooted in research and evidence-based care. Our nurses reflect the rich diversity of our members and communities and provide culturally responsive and competent care that promotes 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.
Hear From Our People
Caitlin
Inpatient Lactation Consultant
As an RN/IBCLC in Maternal Child, I’m meeting families at a pivotal time — I’m there to help launch a new family into the world. Everything I do has the potential to impact a family’s health for generations to come.
Kimberly
Quality Coordinator RN
In Hawaii, your community is your family — or ‘ohana.’ I am able to provide extraordinary patient-centered care to my ohana.
David
Appointment and Advice RN
The location is fantastic. Kaiser Permanente is all over the country. You can pick almost any environment you want — from ocean to mountain to city. You’ll still be able to contribute to our mission of providing high quality health care at a local facility.
Shawn
BSN, RN
I chose Kaiser Permanente because their staff and providers really show that they care about you. Also, throughout my 12 years of working here I’m always learning something new, and I’ve had many opportunities for growth and development.
Kristen
Relief Charge Nurse
Working as a nurse at Kaiser Permanente has allowed me the perfect flexible schedule so that I can volunteer as Girl Scout Leader and room parent for both my children. My kids know that I am a hardworking mother who can provide, as well as a mom who can be present and be there for them – and that means everything to me.
Jazmin
RN, Advice Nurse
Working for Kaiser Permanente has allowed me to take control of my future and make my goals a possibility. I feel that Kaiser Permanente allows me to keep climbing and moving. Having that ability truly makes me feel empowered.
RN Coordinator, UM/Home Health (FT, Days)
Under direct and indirect supervision manages, analyzes, processes and authorizes referred out home health and home infusion referrals for Portland metro area and Salem/ Longview.
- Under direct and indirect supervision, analyzes referral requests for home health and home infusion to assure they meet established program criteria. Interprets referral limitations, Benefits and communicates this information to members, non-plan providers, NWP providers and other internal staff as appropriate. Receives information from contracted and non-contracted vendors related to the admission of KP members. Processes referrals for contracted vendors in Portland, Salem and Longview according to Provider Contracting agreements and Health Plan Service Agreements. Communicates benefit information to home health and home infusion providers. Accurately provides authorization for home health and home infusion in Tapestry as directed by the Home Health Manager or designee. Amends authorizations under the direction of the Home Health manager or designee. Maintains authorization binders and referral logs. Provides additional data as requested by vendor.
- Implement the Quality Management program plan through the strategic collection and analysis of quality and utilization data for outsourced patients.
- Reviews plan of care and visits appropriate to care needs. Ensures standardization of benefits and services across the region.
- Identifies and assists with timely transitions across programs.
- Under direct and indirect supervision, processes referrals for Portland, Salem and Longview Home Health and Home Infusion when programs are at capacity and require referrals to be processed to outside vendors. Assess vendor capacity to accept new referrals. Secures spot contracts as needed. Provide authorization for services. Accurately maintains referred out statistics. Closes authorizations at end of care episode with discharge date and number of visits or days utilized.
- Monitor Home Health Notice of Non-coverage Line: Remove messages. Send notice of non-coverage to patient or Power of Attorney for signature. Maintain notice of non-coverage log.
- Assist in the development and continuous improvement of the Quality Management
- Program for Continuing Care Services through a variety of planning and evaluation
- activities. Communicate findings of ongoing quality/utilization monitors to appropriate individuals utilizing written and verbal reports, charts and graphics.
- Attends Interdisciplinary Group meetings for outside agencies per manager request. Develops working relationships with outside agencies that includes site visits on an annual basis.
- Minimum one (1) year of quality management or commensurate knowledge/experience.
- Minimum two (2) years of community health/home health/hospice nursing experience.
- Minimum two (2) years as a registered nurse with experience in the care of the elderly.
- Bachelors degree OR four (4) years of experience in a directly related field.
- High School Diploma or General Education Development (GED) required.
- This job requires credentials from multiple states. Credentials from the primary work state are required at hire. Additional Credentials from the secondary work state(s) are required post hire.
- Registered Nurse License (Washington) within 6 months of hire OR Compact License: Registered Nurse within 6 months of hire
- Registered Nurse License (Oregon) within 6 months of hire
- Drivers License (in location where applicable)
- Basic Life Support
- Working knowledge of quality/utilization management, risk management and infection control principles.
- Thorough knowledge of Home Health Medicare certification, state licensure.
- Regulations and The Joint Commission accreditation standards.
- Basic knowledge of continuous quality improvement principles.
- Demonstrates customer-focused service skills.
- Computer/word processing skills.
- Excellent written and verbal communication skills; analytical problem-solving skills; well developed project management skills; competent quantitative skills.
- Experience with working in a setting using Medicare Home Health Conditions of Participation.
- Working knowledge of office machines, including PC-based computer systems (Windows), word processing, spreadsheet applications, data base applications.
- Demonstrates customer-focused service skills.
- Good written and verbal skills
- Knowledge of Home Health Conditions of Participation and The Joint Commission standards.
- Minimum three (3) years of years as a public health nurse in a home health or hospice agency.
- Minimum one (1) year of years supervisory experience.
- Minimum one (1) year of experience in discharge planning/utilization management.
- Thorough knowledge of Kaiser Permanente organization and structure; medical terminology.
- Thorough knowledge of continuous quality improvement principles, tools and practices.
- Effective problem solving, analytical, and organizational skills.
- Working knowledge of KP computer systems including Healthconnect, common membership, and Tapestry.
- Working knowledge of Microsoft Excell.
- Basic knowledge of Provider relations and contractual agreements.
- Ability to work independently with indirect supervision, assimilates technical information, and maintains effectiveness in a busy environment.
- Masters degree in nursing, public health, business or health care administration.
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Industry Leader
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Ranked among the nation's best
Every hospital that's part of the Kaiser Permanente system earned “high performing” recognition in the latest U.S. News and World Report's annual rankings. That means all 39 of our hospitals are among the top 20% in the nation.
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Awarded for excellence
We're proud that so many of our hospitals have earned Magnet status. It shows our real commitment to outcomes, safety, quality, efficiency, and, most importantly, to our nurses.
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Recognizing nurses during Nurses Month in 2022
We're thanking each one of our 65,000 Kaiser Permanente nurses for everything they've done for us and for the nation. Thank you for choosing to be a nurse and for leading our transformation of care.
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Explore a career in nursing
When you join Kaiser Permanente as a nurse, you'll help us boldly transform care while also building a career that offers more opportunities for you to grow.
Experience nursing excellence
At Kaiser Permanente our nurses are leaders, clinicians, researchers, innovators, scientists, and more. It takes an extraordinary team to offer extraordinary care.
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