RN Case Manager - Occupational Health

Job Summary The RN Case Manager functions in a self-directed role with a high degree of autonomy in an expanded clinical role guiding appropriate use of resources for a variety of chronic conditions. RN Case Management Services will have accountability for a designated population defined in conjunction with the clinicians in the medical home, and assists the organization in meeting regulatory service and care needs for these populations. The RN Case Manager works collaboratively as a member of the health care team to deliver high quality health care to patients supporting Kaiser Permanente’s mission, vision and values. The RN Case Manager provides a variety of nursing services both in person, by phone and via electronic media utilizing nursing process and leadership skills to address acute and chronic needs of health plan members and other patients of the Kaiser Permanente Health Care Program. He/she works under the general direction of the designated supervisor and may function in multiple settings within the system, the community and home to provide support for a high‑risk population. Essential Responsibilities Utilize regional population stratification information and processes to identify appropriate members for enrollment into case management in collaboration with clinicians and the health care team. Independently and proactively complete chart reviews, screening calls and full assessments related to the anticipated level of care and document findings using standardized approved documentation tools. Triage findings from member assessments, identify needs and issues, engage patients to define a plan of care and appropriate level of self‑management and interventions; determine level of care and communicate findings and actions to involved care providers through succinct summaries that include findings, actions and further recommendations. With the member/family and appropriate KP staff and providers, develop and document a patient‑centered care plan that addresses short‑term goals that are specific, attainable and measurable. Provide care coordination and management services for members with identified needs, creatively using available and appropriate resources (KP staff, providers, internal and external services) to support the unique needs of each member; facilitate access to services, monitor effectiveness of interventions, and reinforce the treatment plan; advise and coach patients and families; succinctly document interventions in KP HealthConnect as needed to ensure coordination of care and services. Strengthen and improve case management services by establishing strong relationships with clinicians and other health care team members, communicating data on population case‑managed, utilization and outcomes, providing education of staff/clinicians, developing and distributing education tools and materials for member coordination, and contributing to ongoing process improvement including related procedures, policies, patient support and documentation tools. Act as a liaison between the patient and the appropriate care delivery team. Basic Qualifications Minimum five (5) years of nursing experience in acute care or ambulatory care/clinic/extended setting within the last eight (8) years, including at least two (2) of those years in a case management or care coordination role. Graduate of an accredited school of nursing. Additional Requirements Credentials from multiple states; primary work‑state credentials required at hire, additional credentials from secondary work state(s) required post‑hire. Registered Nurse License (Washington) within 6 months of hire or Compact License: Registered Nurse within 6 months of hire. Registered Nurse License (Oregon) within 6 months of hire. Driver’s License (in location where applicable). Basic Life Support required at hire. Case Manager Certificate. Occupational Health Nurse Case Manager Certificate. Knowledge of case management principles. Demonstrated clinical nursing and leadership skills. Ability to work independently in an unstructured environment with minimal supervision. Typing speed of 20 words per minute or more. Effective interpersonal, communication and problem‑solving skills. Willingness to learn computerized information systems. Ability to work within teams and within a dynamic work environment. Customer‑focused service skills. Knowledge of community resources for the care of the elderly and patients with chronic conditions. Ability to organize, coordinate and manage care plans; thorough knowledge of levels of care within outpatient, acute care and extended care settings. Ability to work as part of a multidisciplinary team. Effective written and verbal communication skills. Ability to present reports verbally in a public setting (public speaking). Data entry skills and ability to use Microsoft Word. Understanding of the endocrine system, diabetes mellitus pathophysiology and complications, and treatment of emergent situations. Knowledge of Type 1 and Type 2 diabetes and the role/action of various insulins and oral agents. Working knowledge of current diabetic tools used by the diabetic population. Preferred Qualifications Minimum two (2) years of experience in case management, care coordination or population care. Previous experience with population care/case management, triage and advice. Microsoft Word, Excel and Health Connect experience. Experience with quality management methodology and utilization management. Case Management Certification. Current or future bachelor’s degree in nursing or related field. Certified Diabetes Educator (CDE) preferred. Bilingual Spanish preferred. External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran or disability status. #J-18808-Ljbffr Kaiser Permanente