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Quality Utilization Coordinator Home Health Hospice

Location: Santa Clara, CA Job Number: 702990 Date posted: 06/12/2018
Description: Coordinates quality, utilization and risk management activities for the Home Care Agency; provides technical, educational, consultative, and coordinating support to assigned areas.

Essential Functions:
  • Assists in the coordination of the quality management/utilization management department activities. Acts as a consultant for appropriate departments on quality management, utilization management and risk management activities.
  • Assists with quality management studies through data collection, data input and report development. Provides objective assessment of important aspects of patient care through ongoing chart review with preestablished criteria.
  • Facilitates interdisciplinary collaboration for development of patient care paths. Reports all occurrences which may lead to medical center liability and follows up as necessary.
  • Serves as a member of the QM and/or UM Committees as needed. Attends and/or participates in committee meetings as needed. Assists in orientation and training; in formulating and evaluating policies and procedures.
  • Performs special projects as assigned, such as statistical reports for state, federal, and local agencies. Assists the director of quality and utilization management for QM and UM in the formulation of department goals and objectives.
  • 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.

  • Basic Qualifications:
    Experience
  • Minimum three (3) years of home care nursing experience or quality utilization review experience.
    Education
  • Bachelor's degree in nursing or related field OR four (4) years of experience in a directly related field.
  • High School Diploma or General Education Development (GED) required.
    License, Certification, Registration
  • Must have a current RN license in California.

    Additional Requirements:
  • Current working knowledge of The Joint Commission, NCQA and Title 22 and federal standards/regulations.
  • Strong problem solving, project management, group facilitation and teamwork skills.
  • Demonstrate knowledge of adult learning theories.
  • Demonstrate ability to assess or evaluate patient medical records as it relates to quality of care and systems analysis.
  • Demonstrate knowledge of quality improvement, statistical analysis, and accreditation and licensing processes.
  • Must be able to work in a Labor/Management Partnership environment.

    Preferred Qualifications:
  • Supervisory experience preferred.
  • Valid CA driver's license with personal means of transportation preferred.
  • PC literate, Microsoft Office applications preferred.

    Additional Preferred Qualifications:
  • Home Health and Hospice experience required.
  • Intermediate MS Excel skills preferred.
  • Ability to multi-task and communicate using SBAR format.

    Primary Location: California,Santa Clara,Santa Clara 3900 Freedom Support Scheduled Weekly Hours: 0 Shift: Day Workdays: Mon - Fri Working Hours Start: On-Call Working Hours End: On-Call Job Schedule: Call-in/On-Call Job Type: Standard Employee Status: Regular Employee Group/Union Affiliation: Salaried, Non-Union, Exempt Job Level: Individual Contributor Job Category: Nursing Licensed Specialty: Continuing Care (Home Health / Hospice / SNF) Department: Home Health Travel: Yes, 20 % 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.
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