Case Manager Utilization RN - Pipeline Variable Shifts and Schedules

Kaiser Permanente is a renowned integrated managed care consortium, well known for providing comprehensive healthcare services that combine medical care, hospital, and insurance services into one seamless experience. Serving millions of members across the United States, Kaiser Permanente prides itself on its commitment to fostering a healthier community through its innovative healthcare delivery model. This model emphasizes preventive care, extensive health education, and coordinated treatment plans designed to improve patient outcomes. The organization is currently expanding its hospital facilities in the Riverside Service Area, enhancing its ability to serve the growing population with quality care and state-of-the-art resources. This expansion provides exciting career opportunities for dedicated healthcare professionals looking to make a profound impact in the medical field. Kaiser Permanente's work environment promotes collaboration, continuous learning, and respect for diverse perspectives, making it an excellent place for nurses and healthcare professionals to thrive and advance their careers.

The role available is that of a nurse working collaboratively with physicians to coordinate patient admissions and evaluate the appropriateness of inpatient hospital stays. This position is essential in ensuring that patients receive care that matches their medical needs and facilitates safe and effective discharge planning. The nurse acts as an indirect caregiver and patient advocate, managing patients cost-effectively without compromising the quality or continuity of care. They will work directly with patients, families, and a multidisciplinary healthcare team to develop discharge plans, facilitate transfer coordination, and provide education tailored to patients’ needs post-discharge. This includes compliance with regulatory requirements and post-stabilization notifications as mandated by law.

In this role, nurses will participate actively in bed huddles, utilization review, and quality management activities across various clinical settings such as inpatient, outpatient, emergency, and non-Kaiser facilities. They will coordinate transfers to appropriate healthcare facilities while adhering to numerous regulatory and accreditation standards including The Joint Commission (TJC), Centers for Medicare & Medicaid Services (CMS), and National Committee for Quality Assurance (NCQA), among others. Kaiser Permanente values candidates who possess a strong ability to multitask, work well within a multidisciplinary team, and thrive in fast-paced environments.

This position requires a minimum of two years of combined RN experience in acute care or case management. Successful candidates must hold a current Registered Nurse license in California and Basic Life Support certification. The role demands demonstrated skills in utilization review, discharge planning, regulatory compliance, and proficient communication and organizational capabilities. Preferred candidates will have a Bachelor’s degree in nursing or a healthcare-related field, enhancing their ability to contribute to the comprehensive care management of patients. Salary and employment type details are to be confirmed upon application, but the role promises a fulfilling career path with a leading healthcare institution. If you are passionate about providing patient-centered care and want to be part of a pioneering healthcare organization, submitting your interest in this opportunity at Kaiser Permanente in Riverside can be your next career milestone.