RN Care Manager-Quest Integration

Description:

Job Summary:

Completes face to face Health Functional Assessments (HFA) to identified members, as directed by DHS guidelines both in the community and health care institutional facilities. Develops a client focused QI service plan collaboratively with primary care physician (PCP) and other decision makers. Assists with access to medical care and services. Coordinates all home community based services, supplies and equipment, for adults and children needing Long Term Support and Services (LTSS) to live independently in the community.
Essential Responsibilities:

• Provides care management (CM) and care coordination to both QI community and institutional members. Completes the Face to Face Health Functional Assessment and Service plan. Care management is provided across the continuum of health care needs - the community, hospital, skilled nursing facility or institution.
• Maintains required documentation using KPHC electronic health record. Updates members service plan, updates and documents assessments and health care in medical records to indicate progress, changes and continuity of care.
• Works closely with the Member Care Services Associate to navigate home community based services, supplies and equipment for LTSS needing members.
• Promotes Early and Periodic Screening, Diagnosis and Treatment (EPSDT) for members 0-20 years of age. Works closely with Member Care services Associates for EPSDT tracking and audits.
• May provide direct patient care per DHS Face to Face HFA requirements.
• May perform patient care to the extent necessary to maintain clinical expertise, competency, and licensing necessary to fulfill job responsibilities and to direct the provision of care on the unit.
• Provides direct patient care on an as needed basis. Provides services that are within scope of license and in compliance with all legal, regulatory, and policy requirements relevant to clinical role performed.
• Incorporates the KP Nursing Vision, Model and Values throughout their Nursing Practice.

Basic Qualifications:
Experience

• One (1) year Case Management experience in a hospital or clinical setting.

Education

• Bachelors degree in nursing OR four (4) years of experience in a directly related field.

License, Certification, Registration

• Driver's License (from any state) required at hire

• Registered Nurse License (Hawaii) required at hire

• Basic Life Support from American Heart Association

Additional Requirements:

• Demonstrated knowledge of and skill in adaptability, conflict resolution, decision making, customer service, influence, interpersonal relations, oral communication, problem solving, teamwork and written communication.
• Demonstrated knowledge of and skill in word processing.

Preferred Qualifications:

• One (1) year recent experience in a clinical area or equivalent preferred.
• Community case management experience preferred.

Primary Location: Hawaii,Wailuku,Wailuku Medical Offices
Scheduled Weekly Hours: 40
Shift: Day
Workdays: Mon, Tue, Wed, Thu, Fri
Working Hours Start: 08:00 AM
Working Hours End: 05:00 PM
Job Schedule: Full-time
Job Type: Standard
Worker Location: Flexible
Employee Status: Regular
Employee Group/Union Affiliation: NUE-HI-01|NUE|Non Union Employee
Job Level: Individual Contributor
Department: Regional Administrative Office - Med Ofc- Quest Medical Mgt - 1208
Pay Range: $121500 - $157190 / year 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: Yes, 50 % of the Time
Flexible: Work location is on-site at a KP location, with the flexibility to work from home. 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.