Acute Care Patient Coordinators are Registered Nurses who independently assure patients are admitted to the correct level of care for accurate billing and reimbursement, provide quality, cost effective clinical coordination/care management in the acute care and emergency care settings, manage patients with routine and complex discharge planning needs by: independently assessing needs, developing and implementing plans of care for transitions across care settings. Acute Care Patient Coordinators also serve as expert resource consultants and educators for physicians and other health care team members in discharge transition of care, coordination of internal and community resources, and support the evaluation and improvement of systems of care to support the optimal utilization of health care resources, while maintaining quality of patient care. The Acute Care Patient Coordinator assumes primary accountability for anticipating, assessing, developing, implementing, documenting, advising, and communicating a safe discharge plan of care for patients with complex care needs.
Essential Functions:
- Ensures review of all Kaiser Permanente patients admitted to service area hospitals for appropriateness of admission; admission to the appropriate level of care status; length of stay consistent with medical and/or surgical criteria; and, ensures authorization for hospitalization is received from non-Kaiser payer sources
- Facilitates entries in patient charts that reflect and support definitive diagnoses and coding
- Ensures coordination of care toward timely discharge for routine and complex medical/surgical patients in hospital setting; by: Independently and proactively completing assessments which are thorough, timely, age appropriate, and reflect psychosocial support systems, care needs, benefit array, level of care determinations, and document same for designated population of patients
- Developing safe discharge plans by working with patients, families, and health care teams to develop a mutually agreeable plan of care that creatively optimizes the use of all available and appropriate resources to support the unique and particular needs of each patient on a case by case basis. Utilize case/family conferences and consults to develop these care plans as needed
- Implementing care plans by ordering, brokering, and advocating for the patient and family, while educating the patient, family, and health care team about options and alternatives.
- Acting as KP 'ambassador' to provide member information to care facilities (SNF, ICF, assisted living, adult foster homes, residential care facilities) and problem-solve/facilitate any issues which present barriers to safe transfers and the provision of quality care, such as: special equipment needs, symptom/behavior management, financial assessment and plan, clinical instability and complex care needs (IV therapy, enteral feedings, wound care, therapy needs)
- Provides education and program development functions
- Ensures systematic and ongoing contact with hospital staff/other Kaiser departments (CCS, LTC, Expanded Care, DME, HH, Hospice) to share information regarding care coordination role and ongoing responsibility for acute care/ED patients
Qualifications:
Basic Qualifications:
- 2 years of acute hospital experience with progressive levels of responsibility
- Licensed in Oregon and Washington. Requires license in primary state, (Oregon or Washington) prior to first day of employment. Application for licensure in secondary state must be made within 6 weeks of start date. Licenses in both states required within 6 months of hire.
- Basic Life Support (BLS) for Healthcare Providers within two weeks of hire
- BSN or Bachelor's in a health-care related field
- 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
- Thorough knowledge of principles of teaching and delegation, physical assessment and care planning and appropriate utilization of acute hospital, long-term care and home care resources
- Able to document concise yet thorough clinical documentation of patient assessment and care needs
- Highly effective problem solving, written and verbal communication, organizational and time management skills. Familiarity with and ability to use computers
Preferred Qualifications:
- Recent experience in Home Health Agency or role responsibility for inpatient discharge planning
- 2 years of Medical/Surgical or Critical Care Nursing
- 3 years of recent experience in one or more of the following areas: Hospital Inpatient Discharge Planning, Community Health, Home Health and/or Utilization Management
- MSN
- Current Certification as a Certified Case Manager (CCM) or Accredited Case Manager (ACM)
- Demonstrated ability to interrelate with physicians, nurses and patients
- Demonstrates customer-focused service skills
- Good clinical judgment to assess the needs of patients as they relate to next level of care
- Knowledge of the principles of patient teaching, disease prevention measures, physical assessment and appropriate utilization of acute hospital resources
- Knowledge of Medicare and Medicaid regulations related to eligibility requirements: hospital, nursing facilities, home health and hospice eligibility requirements
- Knowledge of Kaiser Permanente resources
- Able to type 30 WPM with accuracy
Salaryrange:
$87,800- $114,000
External hires must pass a background check/drug screen.
We are proud to be an equal opportunity/affirmative action employer.