Continuing Care Utilization Review Coordinator RN
Company: Kaiser Permanente Zion Medical Center
Location: San Leandro
Posted on: January 26, 2023
Conducts utilization review for in-house patients and/or those
members at contracted facilities. Assists in the discharge planning
- 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
- 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
- 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
- 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
- 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.
- Bachelors degree in nursing or health related field required,
OR four (4) years of experience in a directly related
- Graduate of accredited school of nursing.
- High School Diploma or General Education Development (GED)
License, Certification, Registration
- Registered Nurse License (California)
- Demonstrated knowledge of diagnostic codes.
- Must be able to work in a Labor/Management Partnership
- Clinical expert in area of review preferred.
- Masters degree preferred.
Keywords: Kaiser Permanente Zion Medical Center, San Leandro , Continuing Care Utilization Review Coordinator RN, Healthcare , San Leandro, California
Didn't find what you're looking for? Search again!