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Kaiser Permanente Careers

Licensed Nurses & Physician Assistants

The Front Line of Patient Care

Our nurse professionals embody what it means to provide the best patient interactions possible. They also advance the art and science of nursing in a patient-centered, healing environment.

RN Case Manager - Outpatient Continuing Care, Washington Hospital Center

Location: Washington DC, DC Additional Locations:

Regional Offices-Garrett 11921 Bournefield Wy. St, 11921 Bournefield Wy. Ste. B C & D, Silver Spring,Maryland, 20904
Job Number: 670847 Date posted: 05/15/2018
Description:

For members of a defined population, the nurse case manager is responsible for coordination of appropriate, cost-effective services that enhance a member's quality of life, focus on a member's optimal level of independence, and reduces inappropriate utilization of medical services.



Essential Responsibilities:

  • In close collaboration with the member/member's family, and the multidisciplinary Health Care Team (Primary Care Physicians, Specialty Physicians, and other members of the health plan, the network and the community), assesses the member's health status, functional limitations, psychological status, social support systems, resources, environmental factors, and response to treatment.

  • Plans, implements, manages, coordinates and evaluates a comprehensive plan of care across the care continuum aimed at stabilizing chronic or high risk medical conditions and ensuring appropriate use of medical services and resources. Effectively manages and coordinates assigned caseload consistent with established criteria.

  • Develops, implements, and manages the patient's plan of care through use of comprehensive assessment tools, processes, clinical pathways, and clinical guidelines to evaluate patient's plan of care, including processes to identify and correct deviations from clinical pathways. Identifies and analyzes trends and barriers that may affect patient outcomes.

  • Coordinates, manages, and evaluates services to ensure that they are consistent with the comprehensive plan of care and are delivered in a manner that demonstrates high quality and cost effectiveness.

  • Ensures consistent and reliable documentation of case management activities in compliance with all organization and department standards. Practices within ethical and legal guidelines using established policies and procedures. Maintains confidentiality of patient records, information, and departmental activities involving patient information.

  • Analyzes patient and program outcomes to identify improvements in program, quality and cost effectiveness of case management activities.

  • Develops, implements, and manages case finding and screening processes to identify candidates for case management and to define the appropriate level of case management for members.

  • Actively participates in the referral processes, including eligibility verification, compliance with medical necessity guidelines, and evaluation of outcomes, ensuring that the appropriate information is entered into all relevant data systems.

  • Provides education and consulting services to members, families and caregivers, members of the healthcare team, the health plan staff, and the community.

  • Promotes self-awareness and knowledge of current medical and case management standards in the community, recent innovations in patient care, and availability of alternative community, local, state, and federal resources.

  • Basic Qualifications:

    Experience

  • Three (3) years of clinical experience plus two (2) years of experience in case management are required.

  • Education

  • Bachelor's degree is required. Two (2) additional years of related specialty experience may be substituted for degree requirement.

  • License, Certification, Registration

  • Current RN licensure in assigned jurisdiction is required.

  • Case management or specialty certification is required (or acquired within three years of employment in this position). 



  • Additional Requirements:

  • Additional years of relevant clinical experience may be substituted for the case management experience requirement. Required clinical experience must include at least one (1) year in area of specialty as follows:

  • Geriatric: One (1) year of recent experience with a geriatric and Medicare population is required. Experience with chronic and/or high-risk medical diseases is required, including but not limited to diabetes, CHF, Alzheimer's, dementia, CVA.

  • Pediatric/Adolescent: One (1) year of recent experience with pediatric/adolescent population is required. (Experience with chronic and/or high-risk medical diseases is preferred, including but not limited to asthma, cystic fibrosis, cerebral palsy.)

  • Adult: One (1) year of recent primary care experience with an adult population is required. (Experience with chronic and/or high-risk medical diseases is preferred, including but not limited to diabetes, CHF, COPD, asthma.)

  • Perinatal: One (1) year of recent labor and delivery of predominately high-risk obstetrics is required. (Four (4) years of labor and delivery experience in a high-risk setting are preferred.) Demonstrated competence with medication management is required.

  • Oncology: One (1) year of recent clinical oncology experience is required (hospice certification preferred.)

  • Renal: One (1) year of recent nephrology nursing experience is required. (Two (2) years of recent dialysis nursing experience are preferred.) Demonstrated competence with vascular access management is required.

  • Enrollment in PECOS required.



  • Preferred Qualifications:

  • Experience with computer software programs in a Windows environment is preferred.

  • Knowledge of regulatory issues for the Mid-Atlantic area is preferred.


  • Master's degree is preferred.

  • 5 years of recent combined demonstrated case management experience in an outpatient and acute care setting. Preferred knowledge and proficiency of Epic medical record system. Preferred CCM.  Preferred knowledge of community referral processes and resources.
  • Primary Location: District of Columbia,Washington DC,Washington Hospital Center 110 Irving St. NW Scheduled Weekly Hours: 40 Shift: Day Workdays: Mon, Tue, Wed, Thu, Fri Working Hours Start: 8:30 AM Working Hours End: 5:00 PM Job Schedule: Full-time Job Type: Standard Employee Status: Regular Employee Group/Union Affiliation: UFCW - Local 400 Job Level: Individual Contributor Job Category: Nursing Licensed Department: Outpatient Continuing Care Travel: Yes, 50 % of the Time

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