Continuing Care Utilization Review Coordinator Registered Nurse (Skilled Nursing Experience Highly Preferred)
Redwood City, CaliforniaAt 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.
- Job Type: Full-time
- Job Level: Individual Contributor
- Travel: Yes, 50 % of the Time
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.
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Medical, Vision & Dental
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Retirement Plans
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Educational Opportunities & Tuition Reimbursement
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Supportive Teams & Resources
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Career Growth & Development
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.
What Our People Are Saying
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.”
Stella
Registered Nurse IV
“Kaiser Permanente has taken me on a personal and educational growth journey. I am supported by a culture of excellence that allows me to be dedicated to patients and patients’ families every day at work. What an honor to be part of Kaiser Permanente.”.
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.”
Continuing Care Utilization Review Coordinator Registered Nurse (Skilled Nursing Experience Highly Preferred)
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Conducts utilization review for in-house patients and/or those members at contracted facilities. Assists in the discharge planning process.
- Conducts utilization review for in-house patients and/or members who have been admitted to contracted facilities. Interviews patients/caregivers regarding care after hospitalization.
- Conducts clinical reviews based on established treatment criteria.
- Collaborates with physicians on clinical reviews, keeps them appraised of Kaiser clinical criteria.
- Reviews utilization patterns, identifies trends and problems areas for special studies.
- Assists in collecting and assimilating clinical data to enhance the quality of services.
- Generates quality improvement results.
- Reports and investigates unusual occurrences and questions inappropriate decisions based on their professional expertise.
- Assists other health care providers in the discharge planning process and triaging on alternative unit of care.
- 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.
- Minimum two (2) years of experience in an inpatient setting OR if for Skilled Nursing departments, minimum two (2) years of experience in a skilled nursing facility.
- Minimum one (1) year of utilization experience required.
- Bachelors degree in nursing or health related field required, OR four (4) years of experience in a directly related field.Graduate of accredited school of nursing.High School Diploma or General Education Development (GED) required.
- Driver's License (California)
- Registered Nurse License (California)
- Basic Life Support
- Demonstrated knowledge of diagnostic codes.
- Must be able to work in a Labor/Management Partnership environment.
- Clinical expert in area of review preferred.
- Masters degree preferred.
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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