RN QRM Acute Transitional Case Manager - Multiple Part-Time and Full-Time Positions Available

RN QRM Acute Transitional Case Manager - Multiple Part-Time and Full-Time Positions Available

Primary Location Atlanta, Georgia Employee Status: Regular Schedule Full-time Scheduled Weekly Hours: 40 Shift Day Salary $47.37 - $60.85 / hour Job Number 1445991 Date Posted 09/01/2026 Worker Location: Onsite Submit Interest Description: Sign-On Bonus Available for Eligible External Full-Time and Part-Time Hires! Part-Time and Full-Time Positions Available An All-Inclusive Opportunity! To optimize your experience applying to a job at Kaiser Permanente, we have created a unique and easy all-inclusive process to apply opportunities in this specific specialty for this Service Area relevant to your work experience and interests. This position has been created to source and attract external candidates for current positions that remain unfilled within the organization. If you are a current employee, please visit the careers website for a complete listing of available positions. So, what is next? We have a team dedicated to reviewing submissions for an expedited hiring experience. See what its all about, submit your interest today! Job Summary: Responsible for coordinating care for identified members with complex medical conditions in collaboration with hospital physicians, QRM staff (IPCC, CM, SW, PTSP), practitioners, medical office staff and other providers. The goal is to support and facilitate a smooth transition from the acute care setting or skilled nursing facility to alternative levels of care or home. Collaborates with physicians, telephonic care coordinators, inpatient case management/ social workers, telephonic to create a safe discharge plan for identified complex patients. Key job functions include assessment of identified members, development of a safe discharge plan from acute inpatient, skilled nursing, LTAC and Inpatient Rehab facilities. Coordinates post-acute services and follow- up medical care to ensure continuity of care. The Acute Transitional Case Manager (TCM) will identify and communicate any barriers to discharge plan. Ensures appoints and coordination of post-acute services with vendors. Essential Responsibilities: Responsible for all transitional case management activities outlined above. Conducts timely reviews and refers Transitional Case Management Program or Complex Case Management within designated timeframe per policy and procedure and evaluates priority for continuity of care case management based on established guidelines. Performs a thorough and objective telephonic assessment of the member including physical, psychosocial, environmental, financial, and health status expectation through the use of hospital records, contact with the member/family or significant others. Develops an individual, mutually established plan of care based on the assessment and utilizing motivational techniques, in conjunction with the KP Hospitalists and other practitioners that identifies specific interventions, objectives and goals with anticipated targeted dates for accomplishment. Attends patient care conferences (rounds) as scheduled with QRM physicians, and Telephonic IPCC work together to discuss clinical course, discharge planning and provide feedback on planned interventions, or barriers to care for member self-management to avoid delays and promote smooth transition. Proactively, implements the plan of care and specific interventions that will lead to the accomplishment of goals as defined. This may entail implementation prior to member discharge. Coordinates the resources necessary to accomplish the goals,and makes recommendations for modifications to the plan of care as necessary. Performs telephonic outreach to identified members within 48 hours post hospital discharge and completes assessment of member status. Coordinates and communicates plan of care to the Primary and/or Specialist Care providers, including follow-up appointment. Makes referral to other KP programs for continued care support. Documents all case management interactions and interventions according to departmental guidelines. Coordinates and participates in complex case management conferences on a regular basis for members involved in the care and updates the plan of care as necessary. Continuously coordinates, monitors, tracks and evaluates all care and services rendered to ensure that quality care is being delivered and in the most appropriate setting. Re-assess and reinforce members self-management skills, including symptom and medication management. Acts as a resource to facility Case Managers and discharge planners. Provides case management updates to practitioners and health care teams. Collaborates with the healthcare team to provide referral information and regarding community resource referrals. Arranges, coordinates and facilitates appointments for the member as necessary. Builds effective working relationships with practitioners and other departments within the health plan. Works in conjunction with disease specific population based care department as appropriate. Consults with Chief of QRM for potential non-approvals, benefit exceptions and other issues as appropriate. Assists in the development of guidelines and protocols. Investigates, identifies and reports problems and inefficiencies in existing systems, and recommends changes when appropriate to the Supervisor. Under the guidance of the Supervisor and in consultation with other QRM staff, participates in the coordination, planning, development, implementation, and maintenance of all QRM policies and procedures. Monitors utilization trends concerning inpatient and outpatient care in the market area, keeping appropriate management informed. Refers cases identified as risk management, peer review or quality issues to Quality and Risk Management. Provides documentation regarding any pertinent patient information or arrangements for inclusion in the members medical record. Works cross-functionally with other departments in striving to meet organizational goals and objectives. Participates in call rotation to support after hours and weekend referrals for quality resource management services. Acts as a team coach for respective areas of responsibility regarding enhanced customer service, quality of work performed and productivity of staff. Knowledgeable and compliant with regional personnel policies and procedures. Knowledgeable and compliant with QRM departmental and unit specific policies and procedures. Participates in annual regional and departmental compliance training. Knowledgeable and compliant with Principles of Responsibility. Your access to protected health information (PHI) will be limited to the minimum necessary required to effectively perform your job. May perform other duties as assigned. Other duties as assigned. Basic Qualifications: Experience Minimum three (3) years acute hospital discharge planning or prior experience in case management as an RN. Education High School Diploma or General Education Development (GED) required. License, Certification, Registration Registered Professional Nurse License (Georgia) OR Licensed Clinical Social Worker (Georgia) OR Licensed Master Social Worker (Georgia) Additional Requirements: Complex Case Management experience. Experience acute patient populations including Medicare members. Functional knowledge of computers. Must be able to travel within the Atlanta metro area Preferred Qualifications: Bachelors Degree in Nursing or four (4) years of experience in a directly related field. Primary Location: Georgia,Atlanta,Regional Office - 9 Piedmont Scheduled Weekly Hours: 40 Shift: Day Workdays: Mon, Tue, Wed, Thu, Fri Working Hours Start: 08:30 AM Working Hours End: 05:00 PM Job Schedule: Full-time Job Type: Standard Worker Location: Onsite Employee Status: Regular Employee Group/Union Affiliation: GUP|UFCW|Local 1996 Job Level: Entry Level Department: Regional Office - 9 Piedmont - Rgnl Clinical Innovation - 2808 Pay Range: $47.37 - $60.85 / hour Kaiser Permanente strives to offer a market competitive total rewards package and is committed to pay equity and transparency. The posted pay range is based on possible base salaries for the role and does not reflect the full value of our total rewards package. Actual base pay determined at offer will be based on labor market data, internal alignment, and a candidate's years of relevant work experience, education, certifications, skills, and geographic location. Travel: No 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. 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. Expected Employee Conduct Back to nav Navigating the Hiring Process We're here to support you! Having trouble with your account or have questions on the hiring process? Please visit the FAQ page on our website for assistance. Need help with your computer and browser settings? Please visit the Technical Information page for assistance or reach out to the web manager at View email address on click.appcast.io . Do you need a reasonable accommodation due to a disability? Reasonable accommodations may be available to facilitate access to, or provide modifications to the following: Online Submissions Pre-Hire Assessments Interview Process If you have a disability-related need for accommodation, please submit your accommodation request and someone will contact you.