SNF, RN Coordinator

About This Role

Optimize clinical care efficiency, effectiveness, and quality for Kaiser Permanente patients in a Skilled Nursing Facility (SNF) setting. This role focuses on utilization, case/care management, and customer service to enhance patient and family satisfaction and assure effective transitions of care.

Responsibilities

• Enhance the delivery of case/care management on a daily basis and assist the team to enhance SNF quality at contracted facilities
• Partner with facilities and rehabilitation consultants to analyze quality outcome data and negotiate performance improvement activities
• Consult with facility management and SNF Operations Manager in setting annual quality improvement goals
• Address high risk, high volume patient care activities through continuous quality improvement tools and techniques
• Facilitate root cause analyses and develop systems to improve clinical quality and patient safety
• Facilitate efficient care delivery by supporting clinicians, participating in patient care conferences, and assisting with care goal development
• Identify barriers to achieving patient discharge and assist care teams in overcoming them
• Collaborate with facility teams to identify and address patient resource needs for achieving desired clinical outcomes and patient safety
• Interpret utilization criteria for patients prior to and during SNF admission, including Medicare criteria and Milliman Care Guidelines
• Educate patients and families regarding utilization criteria and appeal rights, and provide notices of non-coverage
• Work closely with community physicians and facilities in managing out of area patients
• Enhance customer service by meeting with patients and family members, serving as a liaison, and addressing complaints

Requirements

• Minimum two years as a Case Manager/Care Coordinator
• Minimum two years of geriatric clinical practice in home health, hospice, hospital or long-term care setting
• BSN or bachelors degree in a health-care related field or currently enrolled in a BSN program, OR four years of experience of case management or equivalent experience in a directly related field
• High School Diploma or General Education Development (GED)
• Registered Nurse License (Washington) within 2 months of hire OR Compact License: Registered Nurse within 2 months of hire
• Registered Nurse License (Oregon) within 2 months of hire
• Driver's License (in location where applicable) required at hire
• Basic Life Support required at hire
• Demonstrated ability to interrelate with physicians, nurses, support staff, and patients in interdisciplinary approach
• Demonstrated ability to work as part of a team and work as a constant patient advocate
• Basic physical, psychosocial, functional assessment skills
• Familiar with care processes and systems in settings internal and external to Kaiser Permanente
• Familiar with and able to collaborate with Kaiser Permanente and community resources
• Ability to work with angry or hostile individuals in high pressure situations
• Ability to effectively provide culturally competent care
• Able to develop concise and thorough documentation of patient clinical assessment and care needs
• Highly effective problem solving, written and verbal communication, customer service, organizational and time management skills
• Familiarity with and ability to use computers
• Ability to collect, analyze and report meaningful quality and utilization data
• Working knowledge of admission criteria for SNF, Home Health, Hospice, Long Term Acute Care and Inpatient Rehabs

Qualifications

• BSN or bachelors degree in a health-care related field or currently enrolled in a BSN program, OR four (4) years of experience of case management or equivalent experience in a directly related field. High School Diploma or General Education Development (GED) required.
• Minimum two (2) years as a Case Manager/Care Coordinator. Minimum two (2) years of geriatric clinical practice in home health, hospice, hospital or long-term care setting.

Nice to Have

• Minimum two years of previous utilization and quality management experience
• Previous experience working in the long-term care setting
• CPHQ certification in Health Care Quality Improvement or Certified Case Manager (CCM) or Certification in geriatric nursing
• Knowledge of Medicare SNF criteria
• Bachelor's degree in nursing

Skills

* Required skills