Utilization Review RN - Discharge Planning, On Call, BWMC - Utilization Review

Company: Kaiser Permanente
Location: Glen Burnie
Posted on: March 20, 2023

Job Description:

Utilization Review RN - Discharge Planning, On Call, BWMCDescription:

Job Summary:

The Patient Care Coordinator is responsible for utilization review, discharge planning and transitions in care, in collaboration with MAPMG rounder in acute or alternative settings of care.

Essential Responsibilities:

* Utilization Review. According to department policy, procedure and protocols, consistently apply and verbally communicate approved utilization review criteria and guidelines for services delivered in acute or alternative care settings.
* Eligibility and Benefit Verification. Confirm eligibility status and ensure the appropriate administration of benefits in accordance with department policies and procedures.
* Assessing Right Venue of Care with Hospitalist. Collaboration with Hospitalist to assess the appropriate level of care for patients (i.e., Medical Unit, Surgical Unit, Tele Unit, TCU, ICU) and post- (Home, Continuum or Community-based Services) hospitalization.
* Coordination of Care. Driving patient care plan through assuring daily plan is executed, and management of transitions and post-hospital care.
* Effective Discharge Planning. Prompt, clinically appropriate discharge planning beginning at time of admission.
* Variance Management. Timely steps in identification of delays in throughput, escalation to correct delays, and recording delays to identify patterns and trends that will require corrective actions.
* Quality Screening. Demonstrate competency to assess all aspects of care across the continuum for variations from quality and utilization standards.
* Performs other related duties as directed.

32 hours per month availability required. Must work weekends and holidays.

Basic Qualifications:

Experience

* Minimum one (1) year of experience as an RN in an acute care setting.

Education

* N/A

License, Certification, Registration

* This job requires credentials from multiple states. Credentials from the primary work state are required before hire. Additional Credentials from the secondary work state(s) are required post hire.
* Registered Nurse License (Virginia) within 6 months of hire AND Registered Nurse License (Maryland) within 6 months of hire

OR

* Compact License: Registered Nurse within 6 months of hire
* Registered Nurse License (District of Columbia) within 6 months of hire
* Basic Life Support

Additional Requirements:

* Annually: Successful completion of PCC Assessment of Critical Skills. Passing score on inter-rater reliability.

Preferred Qualifications:

* BSN preferred.

Primary Location: Maryland,Glen Burnie,Baltimore Washington Medical Center Scheduled Weekly Hours: 1 Shift: Day Workdays: Sun, Mon, Tue, Wed, Thu, Fri, Sat Working Hours Start: 08:00 AM Working Hours End: 05:00 PM Job Schedule: Call-in/On-Call Job Type: Standard Employee Status: Regular Employee Group/Union Affiliation: M37-UFCW-Local 27 Job Level: Individual Contributor Department: Baltimore Washington Med Centr - UR-Discharge Planning - 1808 Pay Range: $52.4 - $58.71 Travel: No At Kaiser Permanente, equity, inclusion and diversity are inextricably linked to our mission, and we aim to make it a part of everything we do. We know that having a diverse and inclusive workforce makes Kaiser Permanente a better place to receive health care, a more supportive partner in our communities we serve, and a more fulfilling place to work. Working at Kaiser Permanente means that you agree to and abide by our commitment to equity and our expectation that we all work together to create an inclusive work environment focused on a sense of belonging and wellbeing.

Kaiser Permanente is an equal opportunity employer committed to a diverse and inclusive workforce. Applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), age, sexual orientation, national origin, marital status, parental status, ancestry, disability, gender identity, veteran status, genetic information, other distinguishing characteristics of diversity and inclusion, or any other protected status.

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Keywords: Kaiser Permanente, Baltimore , Utilization Review RN - Discharge Planning, On Call, BWMC - Utilization Review, Healthcare , Glen Burnie, Maryland