Case Management Specialist RN-PD (Bilingual)

Job Summary:Works collaboratively with an assigned panel of physicians to manage the patients specialized needs. The managing team does differ according to the chronic disease. Duties include assessment to identify member needs and development of specific care management plan to address needs. In conjunction with the Physician, implements care/treatment plan by coordinating access to health services across multiple providers/disciplines, monitors care, makes determination to arrange transportation and transfer patient if indicated, identifies cost-effective measures, makes recommendations for alternative levels of care and utilization of resources, promotes self-care management and ensures paper work is completed. Is an indirect caregiver. Complies with other duties as described. Must be able to work collaboratively with the Multidisciplinary team.Essential Responsibilities:Evaluates and identifies members needs.Interfaces with Primary Care Physicians, Specialists and various disciplines on the development of case management plans/programs.Monitors and evaluates the effectiveness of the case management plans and modifies as necessary.Coordinates the interdisciplinary approach to providing continuity of care, including utilization management, transfer coordination, discharge planning and obtaining all authorizations/approvals/transfers as needed for outside services for patients/families.Acts as a clinical liaison, per their specialty, with outside agencies such as County CCS, non-plan facilities, outside providers, employers and/or workers compensation carriers and third party administrators.Prepares reports, communicates program changes to appropriate staff and develops protocols in accordance with state regulations.Acts as a patient advocate and educator to assure that the patient has the knowledge to care for his/her condition and patient is educated and empowered to be responsible for participating in the plan of care.Develops individualized patient/family education plan focused on self-management, delivers patient/family education specific to a disease state.Develops and updates training and educational materials and presents to appropriate staff, members and families.Facilitates patients return to normal daily activities by teaching and making appropriate referrals for outside services/continued care.Consults with internal and external physicians, health care providers, discharge planners, and outside agencies regarding continued care/treatment or hospitalization or referral to support services or placement.May need to facilitate transportation and housing arrangements for patient.Coordinates transmission of clinical and benefit treatment to patients, families and outside agencies.Participates in data collection and analysis of clinical outcomes of care and customer satisfaction standards.Participates in the formulation and implementation/monitoring of action strategies and outcomes of care or customer service.Ensures that accurate records are maintained of the care associated with each patient.Interprets regulations, health plan benefits, policies, and procedures for members, physicians, medical office staff, and contract providers and outside agencies.Basic Qualifications:ExperienceMinimum two (2) years clinical experience as an RN in an acute care or ambulatory care setting required.EducationBachelors degree orEquivalent four (4) experience required.License, Certification, RegistrationRegistered Nurse License (California)Basic Life SupportAdditional Requirements:Demonstrated ability to utilize/apply the general and specialized principles, practices, techniques and methods of utilization review/management, care coordination, transfer coordination, discharge planning or case management.Working knowledge of regulatory requirements and accreditation standards (TJC, Medicare, Medi-Cal, etc.).Demonstrated ability to utilize written and verbal communication, interpersonal, critical thinking and problem-solving skills required.Computer literacy skills required.Bilingual (English/Spanish) Level II required.Preferred Qualifications:Case Management Certification or certification in the area of specialty preferred.Bachelors degree in nursing or healthcare related field preferred.Notes:Must successfully pass or have passed the bilingual test (within the last 12 months), or be active in the QBS program.COMPANY: KAISERTITLE: Case Management Specialist RN-PD (Bilingual)LOCATION: Riverside, CaliforniaREQNUMBER: 1278457External 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, state and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran, or disability status.

Kaiser Permanente Culture:

Located in the dynamic community of Calimesa, CA, Kaiser Permanente is a beacon in the healthcare industry, offering diverse job opportunities for those dedicated to making a difference in healthcare services. As a premier healthcare provider, we are dedicated to excellence and innovation across various healthcare sectors, positioning us as a top choice for professionals seeking healthcare jobs near Calimesa, CA. Our mission is to deliver unparalleled healthcare services to our community, a commitment that is at the core of our culture and motivates our ongoing search for passionate individuals to join our team.

Kaiser Permanente has become a key player in the Calimesa, CA healthcare landscape, not only by providing exceptional care but also by generating extensive employment opportunities for healthcare professionals. Whether you are a seasoned Case Management Specialist RN-PD (Bilingual) or a recent graduate ready to embark on your healthcare career, Kaiser Permanente offers a supportive and dynamic environment where your talents are valued and your professional development is encouraged. With our broad operations in Calimesa, CA, we are continually seeking skilled individuals to fill roles in various categories, ensuring a steady demand for healthcare professionals in our community.

Kaiser Permanente is at the forefront of addressing the growing need for quality healthcare in Calimesa, CA, offering numerous job openings for those searching for healthcare positions in their vicinity. Our dedication to adopting the latest healthcare technologies and methodologies means our team is ever-expanding, with a keen interest in hiring professionals such as (RN) Case Managers for Assisted Living, Associate Dentists, Clinical Pharmacists, Field Training Audiologists, Occupational Therapists, Social Workers, and Staff Physical Therapists, who are eager to positively impact our patients' lives. Joining Kaiser Permanente places you among a group of dedicated professionals committed to delivering the best healthcare in Calimesa, CA, and beyond.

For individuals in Calimesa, CA seeking healthcare jobs near them, Kaiser Permanente offers a unique chance to work in a cutting-edge facility that prioritizes both the professional growth of its staff and the health of its patients. We recognize the significance of local employment opportunities in building a strong community and proudly provide a variety of positions that accommodate the diverse expertise within the healthcare field. From clinical roles like (RN) Case Managers, Associate Dentists, and Clinical Pharmacists to specialized positions such as Field Training Audiologists, Occupational Therapists, Social Workers, and Staff Physical Therapists, Kaiser Permanente is eager to attract and retain top talent in and around Calimesa, CA.

In conclusion, Kaiser Permanente is more than a leader in healthcare; we are a significant employer in the healthcare sector within Calimesa, CA. Our dedication to excellence in healthcare services is paralleled by our commitment to creating job opportunities for those seeking healthcare positions close to home. By choosing to grow your career with Kaiser Permanente, you're not just joining a team of exceptional healthcare professionals; you're also contributing to the well-being of the Calimesa, CA community. We invite you to explore the exciting career opportunities at Kaiser Permanente and take the first step toward a rewarding healthcare career, right here in Calimesa, CA.

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