Quality Utilization Coordinator Home Health Hospice
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- 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.
- Minimum three (3) years of home care nursing experience or quality utilization review experience.
- 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.
- 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.
- Supervisory experience preferred.
- Valid CA driver's license with personal means of transportation preferred.
- PC literate, Microsoft Office applications preferred.
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.