Case Management Specialist RN - Per Diem

Job Summary Works collaboratively with an assigned panel of physicians to manage the patients' specialized needs. The managing team differs according to the chronic disease. Duties include assessment to identify member needs and development of specific care management plans to address those needs. In conjunction with the physician, implements the care/treatment plan by coordinating access to health services across multiple providers and disciplines, monitors care, determines transport arrangements, identifies cost-effective measures, recommends alternative levels of care, promotes self‑care management, and ensures paperwork is completed. The role functions as an indirect caregiver and collaborates with the multidisciplinary team. Essential Responsibilities Evaluate and identify members’ needs. Interface with primary care physicians, specialists, and various disciplines to develop case management plans and programs. Monitor and evaluate the effectiveness of case management plans and modify as necessary. Coordinate the interdisciplinary approach to providing continuity of care, including utilization management, transfer coordination, discharge planning, and obtaining authorizations, approvals, and transfers as needed for outside services. Act as a clinical liaison with outside agencies such as county CCS, non‑plan facilities, outside providers, employers, workers’ compensation carriers, and third‑party administrators. Prepare reports, communicate program changes, and develop protocols in accordance with state regulations. Advocate for and educate patients to ensure they have the knowledge to manage their condition and are empowered to participate in the care plan. Develop individualized patient/family education plans focused on self‑management and deliver disease‑specific education. Create and update training and educational materials and present them to staff, members, and families. Facilitate patients’ return to normal daily activities by teaching and making appropriate referrals for outside services and continued care. Consult with internal and external physicians, health care providers, discharge planners, and outside agencies regarding continued care, treatment, hospitalization, or referral to support services or placement. Facilitate transportation and housing arrangements for patients when needed. Coordinate the transmission of clinical and benefit information to patients, families, and outside agencies. Participate in data collection and analysis of clinical outcomes and customer satisfaction standards. Participate in the formulation and implementation/monitoring of action strategies and outcomes of care or customer service. Ensure accurate records are maintained of care associated with each patient. Interpret regulations, health plan benefits, policies, and procedures for members, physicians, medical office staff, contract providers, and outside agencies. Basic Qualifications Minimum two (2) years of clinical experience as an RN in an acute or ambulatory care setting. Education Bachelor’s degree or equivalent four (4) years of experience. License, Certification, Registration Registered Nurse License (California). Basic Life Support certification. Additional Requirements Demonstrated ability to utilize/write and verbal communication, interpersonal, critical thinking, and problem‑solving skills. Working knowledge of regulatory requirements and accreditation standards (TJC, Medicare, Medi‑Cal, etc.). Computer literacy skills. Preferred Qualifications Case Management Certification or related specialty certification. Bachelor’s degree in nursing or a health‑care related field. Notes Work hours/days may vary. Training schedule may differ. Will cross‑train to other functions of the department and may be assigned to other LAMC locations. Primary Location California, Los Angeles, 1505 N. Edgemont Medical Offices Job Details Scheduled Weekly Hours: 1 Shift: Day Workdays: Mon, Tue, Wed, Thu, Fri Working Hours Start: 08:00 AM Working Hours End: 04:30 PM Job Schedule: Per Diem Job Type: Standard Worker Location: Onsite Employee Status: Regular Employee Group/Union Affiliation: B21|AFSCME|SCNSC Job Level: Individual Contributor Department: Edgemont MOB - Neuro‑Surgery‑Regular Clinic - 0806 Pay Range: $72.95 - $89.28 per hour Travel: Yes, 10 % of the Time Work Setting: Onsite 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. #J-18808-Ljbffr