(Immediate Start) Continuing Care Utilization Review Coordinator RN - SNF
Company: Kaiser
Location: San Jose
Posted on: June 24, 2025
|
|
|
Job Description:
Job Description Job Summary: Conducts utilization review for
in-house patients and/or those members at contracted facilities.
Assists in the discharge planning process. Essential
Responsibilities: - Conducts utilization review for in-house
patients and/or members who have been admitted to contracted
facilities. Interviews patients/caregivers regarding care after
hospitalization. - Conducts clinical reviews based on established
treatment criteria. - Collaborates with physicians on clinical
reviews, keeps them appraised of Kaiser clinical criteria. -
Reviews utilization patterns, identifies trends and problems areas
for special studies. - Assists in collecting and assimilating
clinical data to enhance the quality of services. - Generates
quality improvement results. - Reports and investigates unusual
occurrences and questions inappropriate decisions based on their
professional expertise. - Assists other health care providers in
the discharge planning process and triaging on alternative unit of
care. - Counsels on Medicare and health care plan coverage. -
Coordinates referrals to appropriate agencies/facilities. - Kaiser
Permanente conducts compensation reviews of positions on a routine
basis. At any time, 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.
Secondary Functions: - Varies from Mon-Fri. Basic Qualifications:
Experience - Minimum two (2) years of experience in an inpatient
setting OR if for Skilled Nursing departments, minimum two (2)
years of experience in a skilled nursing facility. - Minimum one
(1) year of utilization experience required. Education - Bachelors
degree in nursing or health related field required, OR four (4)
years of experience in a directly related field.Graduate of
accredited school of nursing.High School Diploma or General
Education Development (GED) required. License, Certification,
Registration - Driver's License (California) - Registered Nurse
License (California) - Basic Life Support Additional Requirements:
- Demonstrated knowledge of diagnostic codes. - Must be able to
work in a Labor/Management Partnership environment. Preferred
Qualifications: - Clinical expert in area of review preferred. -
Masters degree preferred. PrimaryLocation : California,San Jose,San
Jose 50 Great Oaks HoursPerWeek : 20 Shift : Day Workdays : Mon,
Tue, Wed, Thu, Fri WorkingHoursStart : 08:30 AM WorkingHoursEnd :
05:00 PM Job Schedule : Part-time Job Type : Standard Employee
Status : Regular Employee Group/Union Affiliation :
NUE-NCAL-09|NUE|Non Union Employee Job Level : Individual
Contributor Job Category : Nursing Licensed & Nurse Practitioners
Department : San Jose Hospital - OSM Svc Admin-SNF - 0201 Travel :
Yes, 75 % of the Time Kaiser Permanente is an equal opportunity
employer committed to fair, respectful, and inclusive workplaces.
Applicants will be considered for employment without regard to
race, religion, sex, age, national origin, disability, veteran
status, or any other protected characteristic or status.
Keywords: Kaiser, Modesto , (Immediate Start) Continuing Care Utilization Review Coordinator RN - SNF, Healthcare , San Jose, California
