Coordinator, Inpt Care RN SNF Hsp Job in Brooklyn Heights, Ohio US
Coordinator, Inpt Care RN SNF Hsp
Includes on site and/or telephonic review and coordination of care for Kaiser Permanente members located in Acute Care, Rehabilitation, and Skilled Nursing Facilities. Essential Functions: - One of 11 Inpatient Care Coordinators managing an average SNF census of 25 members per day /or Inpatient hospital census of 1 to 40 members - Licensed Personnel (Registered Nurse Licensed Practical Nurse): provides care to patients according to the rules laws promulgated by the Ohio Board of Nursing as articulated in the Ohio Administrative Revised Codes - Is accountable for maintaining all required licensure, certification department/ position specific competencies - Makes clinical decisions applies critical thinking while reviewing member's medical record to promote continuity appropriate level of care for referrals for Inpatient, SNF, outpatient care - Works collaboratively w/ physician staff - Interprets applies appropriate clinical criteria (InterQual, Milliman Care Guidelines, Medicare, internally developed criteria) based on individual needs of member, clinical information, assessment of local delivery system makes decisions or involves physicians or other disciplines to determine appropriate level of care for coordination across the continuum of care - Monitors State Federal Regulation compliance in contracted facilities - Acts as a resource for interpreting clinical scenarios provide benefit interpretation as it applies to those clinical scenarios, facilitate patient education regarding disease process follow-up - Makes follow up appointments referrals for post discharge care - Initiates /or participates in member/family conferences to update member's status w/ member/family to plan for continuum of care Qualifications: Basic Qualifications: - Minimum of 3-5 years experience in Medical Surgical Nursing - Proven experience in utilizing operational reports (financial, customer satisfaction, clinical) - Bachelors of Science Degree in Nursing or equivalent in education experience - Current RN licensure in the State of Ohio - Current BCLS certification per American Heart Association guidelines; - Valid Ohio Drivers License - Demonstrated competency in adult teaching/learning principles - Demonstrated competency in word processing functions - General knowledge base of community based resource - History of working successfully w/ physicians other members of the health care team w/out direct supervision. - Ability to function w/ minimal direct supervision, demonstrate high standards of professional conduct, develop positive working relationships, encourage open communications, demonstrate strong interpersonal skills - Adheres to HIPPA standards Preferred Qualifications: - Two years experience in a Managed Care Organization preferred - Previous experience in case management,SNF, or discharge planning preferred - Previous experience working w/ nationally accepted UM criteria Medicare standards preferred - Masters Degree preferred