- This position, knows and complies with all Kaiser Permanente quality, safety, and emergency policies and procedures. Demonstrates quality and effectiveness in work habits and clinical practice in every interaction with patients, colleagues, providers, and leadership. Ensures patient safety in the preparation and provisioning of care related to but not limited to medications, procedures, infection prevention, fall prevention, including consistent use of two patient identifiers and procedural time outs. Reports safety hazards, accidents and incidents, and unsafe working conditions promptly.
- Determines and manages appropriate levels of care and services; using clinical knowledge, established guidelines and physician consultation.
- Implements changes in contract benefits, state and federal regulations, and established review criteria guidelines.
- Synthesizes and analyzes a large volume of data related to the member, benefits, eligibility, facilities, contracts, and clinical status to identify issues and facilitate problem solving that results in continuity of care, quality of care and optimal resource management for the patient.
- Coordinates care with various internal and external customers to facilitate high quality, timely, and cost effective care and service.
- Consults and educates other staff, physicians, departments and members regarding resource management options that provide high quality while efficiently using available resources.
- Three (3) to five (5) years of clinical experience in healthcare setting, experience in utilization review, case management, discharge planning, and managed care.
- High School Diploma or GED
- Registered Nurse License (Colorado)
- N/A
- Three (3) to five (5) years of hospital experience in ICU, CCU, Med/Surg.
- Associates degree in Nursing
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Quality/Resource Coordinator RN - Denver, United States - Kaiser Permanente
Description
: $2500 sign-on bonus eligible positionUFCW Local 7 - *$42.47-$49.96
"May be entitled to translation/bilingual, shift or other wage premiums as governed by the applicable collective bargaining agreement. Please refer to the respective collective bargaining agreement for additional information on such wage premiums:
Job Summary:
Provides assessment and monitoring of resource utilization, coordinates outside referrals, provider practice patterns, quality of care, and coordination of our members continuing care needs. Maintain and support a culture of compliance, ethics and integrity. Responsible for ensuring ongoing compliance for the department. Maintains knowledge of policies and procedures and performs in accordance with applicable regulatory requirements, external laws and accreditation standards as they relate to the department.
Essential Responsibilities:
Experience
Primary Location: Colorado,Denver,Franklin Medical Offices
Scheduled Weekly Hours: 40
Shift: Day
Workdays: Mon, Tue, Wed, Thu, Fri
Working Hours Start: 12:00 AM
Working Hours End: 11:59 PM
Job Schedule: Full-time
Job Type: Standard
Worker Location: Onsite
Employee Status: Regular
Employee Group/Union Affiliation: C02|UFCW|Local 7
Job Level: Individual Contributor
Department: Waterpark I - Hosp Admin-Hospital Services
Pay Range: $ $52.46 / hour
Sign on bonus: $ The ranges posted above reflect the location in the job posting. The salary range may vary if you reside in a different location or state than the location posted.
Travel: Yes, 5 % of the Time
On-site: Work location is on-site (KP designated office, medical office building or hospital). Worker location must align with Kaiser Permanente's Authorized States policy. At Kaiser Permanente, equity, inclusion and diversity are inextricably linked to our mission, and we aim to make it a part of everything we do. We know that having a diverse and inclusive workforce makes Kaiser Permanente a better place to receive health care, a more supportive partner in our communities we serve, and a more fulfilling place to work. Working at Kaiser Permanente means that you agree to and abide by our commitment to equity and our expectation that we all work together to create an inclusive work environment focused on a sense of belonging and wellbeing.
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. Submit Interest