Case Management Utilization RN, Per Diem Day
Kaiser Permanente · Moreno Valley, CA · 4 wk ago
Healthcare$77.69–$95.08/hrFull-time
We need to output HTML fragment with headings for sections: About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. Only include sections if posting has real specific content.
We need to parse the job posting.
First, job summary: "Works collaboratively with an MD to coordinate and screen for the appropriateness of admissions and Continued stays. Makes recommendations to the physicians for alternate levels of care when the patient does not meet the medical necessity for Inpatient hospitalization. Interacts with the family, patient and other disciplines to coordinate a safe and acceptable discharge plan. Functions as an indirect caregiver, patient advocate and manages patients in the most cost effective way without compromising quality. Transfers stable non-members to planned Health care facilities. Responsible for complying with AB 1203, Post Stabilization notification. Complies with other duties as described. Must be able to work collaboratively with the Multidisciplinary team, multitask and in a fast pace environment."
That's about the role. So we can have
for sections: About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. Only include sections if posting has real specific content.
We need to parse the job posting.
First, job summary: "Works collaboratively with an MD to coordinate and screen for the appropriateness of admissions and Continued stays. Makes recommendations to the physicians for alternate levels of care when the patient does not meet the medical necessity for Inpatient hospitalization. Interacts with the family, patient and other disciplines to coordinate a safe and acceptable discharge plan. Functions as an indirect caregiver, patient advocate and manages patients in the most cost effective way without compromising quality. Transfers stable non-members to planned Health care facilities. Responsible for complying with AB 1203, Post Stabilization notification. Complies with other duties as described. Must be able to work collaboratively with the Multidisciplinary team, multitask and in a fast pace environment."
That's about the role. So we can have About the role
with paragraphs.
Next, "Essential Responsibilities" then a long list of duties. That is responsibilities. So we need a Responsibilities
with - items for each bullet.
We need to extract each bullet. The text after "Essential Responsibilities" is a paragraph with many sentences separated by periods. We need to break into list items. The instruction: Use
- for any list of duties/requirements/benefits. So we should convert each distinct duty into a
- . We need to preserve all substantive information.
Let's parse the responsibilities sentences:
"Plans, develops, assesses and evaluates care provided to members."
"Collaborates with physicians, other members of the multidisciplinary health care team and patient/family in the development, implementation and documentation of appropriate, individualized plans of care to ensure continuity, quality and appropriate resource use."
"Recommends alternative levels of care and ensures compliance with federal, state and local requirements."
"Assesses high risk patients in need of post-hospital care planning."
"Develops and coordinates the implementation of a discharge plan to meet patients identified needs; communicates the plan to physicians, patient, family/caregivers, staff and appropriate community agencies."
"Reviews, monitors, evaluates and coordinates the patients hospital stay to assure that all appropriate and essential services are delivered timely and efficiently."
"Participates in the Bed Huddles and carries out recommendations congruent with the patients needs."
"Coordinates the interdisciplinary approach to providing continuity of care, including Utilization management, Transfer coordination, Discharge planning, and obtaining all authorizations/approvals as needed for outside services for patients/families."
"Conducts daily clinical reviews for utilization/quality management activities based on guidelines/standards for patients in a variety of settings, including outpatient, emergency room, inpatient and non-KFH facilities."
"Acts as a liaison between in-patient facility and referral facilities/agencies and provides case management to patients referred."
"Refers patients to community resources to meet post hospital needs."
"Coordinates transfer of patients to appropriate facilities; maintains and provides required documentation."
"Adheres to internal and external regulatory and accreditation requirements and compliance guidelines including but not limited to: TJC, DHS, HCFA, CMS, DMHC, NCQA and DOL."
"Educates members of the healthcare team concerning their roles and responsibilities in the discharge planning process and appropriate use of resources."
"Provides patients with education to assist with their discharge and help them cope with psychological problems related to acute and chronic illness."
"Per established protocols, reports any incidence of unusual occurrences related to quality, risk and/or patient safety which are identified during case review or other activities."
"Reviews, analyses and identifies utilization patterns and trends, problems or inappropriate utilization of resources and participates in the collection and analysis of data for special studies, projects, planning, or for routine utilization monitoring activities."
"Coordinates, participates and or facilitates care planning rounds and patient family conferences as needed."
"Participates in committees, teams or other work projects/duties as assigned."
That's a lot. We'll include them as
- .
Next, "Experience Basic Qualifications: Two (2) years combined RN experience in an acute care setting or case management required."
That's qualifications/experience. We'll have a
Requirements
maybe? The instruction says sections: About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. We need to decide where to put experience and education etc. Likely "Requirements" for basic qualifications (experience, license). "Qualifications" for preferred qualifications (education). "Skills" for skills like communication, critical thinking, computer literacy, etc.
Let's extract:
Experience: "Two (2) years combined RN experience in an acute care setting or case management required."
Education: "Completion of an accredited RN training program that allows graduates to take RN license exam."
License, Certification, Registration: "Registered Nurse License (California) Basic Life Support"
Additional Requirements: list of demonstrated abilities:
- "Demonstrated ability to utilize/apply the general and specialized principles, practices, techniques and methods of Utilization review/management, discharge planning or case management."
- "Working knowledge of regulatory requirements and accreditation standards (TJC, Medicare, Medi-Cal, etc.)."
- "Demonstrated ability to utilize written and verbal communication, interpersonal, critical thinking and problem-solving skills."
- "Demonstrated ability in planning, organizing, conflict resolution and negotiating skills."
- "Computer literacy skills required."
Preferred Qualifications: "Bachelors degree in nursing or healthcare related field."
Now we need to map to sections.
We could have:
Requirements
for experience, education, license, basic qualifications.
Qualifications
for preferred qualifications (Bachelors degree).
Skills
for the demonstrated abilities (communication, critical thinking, planning, organizing, conflict resolution, negotiating, computer literacy, utilization review knowledge, etc.)
But we need to avoid duplication. Also we need to ensure we don't create sections with filler like "commensurate with experience". Not present.
Pay: The posting includes "Pay Range: $77.69 - $95.08 / hour". That's specific pay info. So we should include a Pay
with that info.
Schedule: The posting includes "Scheduled Weekly Hours: 1 Shift: Day Workdays: Mon, Tue, Wed, Thu, Fri, Sat, Sun Working Hours Start: 08:00 AM Working Hours End: 04:30 PM Job Schedule: Per Diem Job Type: Standard Worker Location: Onsite Employee Status: Regular Employee Group/Union Affiliation: B21|AFSCME|SCNSC Job Level: Individual Contributor Department: Moreno Valley Hospital - Utilization Management - 0801". That's schedule info. So we can include Schedule
with those details.
Benefits: The posting mentions "Kaiser Permanente strives to offer a market competitive total rewards package and is committed to pay equity and transparency. The posted pay range is based on possible base salaries for the role and does not reflect the full value of our total rewards package." That's not specific benefits like health insurance, retirement, etc. It's generic. The instruction says: never create Pay/Schedule/Benefits sections unless the posting actually states them. For Benefits, we need specific benefits statements. The posting does not list specific benefits (like medical, dental, 401k). It only mentions total rewards package generically. That might be considered not specific enough. So we should NOT create a Benefits section.
Now we need to output only HTML fragment, no /, no markdown.
We'll produce:
About the role
... (the job summary paragraph)
Responsibilities
- ...
...
Requirements
- Two (2) years combined RN experience in an acute care setting or case management required.
- Completion of an accredited RN training program that allows graduates to take RN license exam.
- Registered Nurse License (California) and Basic Life Support certification.
Qualifications
- Bachelor's degree in nursing or healthcare related field (preferred).
Skills
- Demonstrated ability to utilize/apply the general and specialized principles, practices, techniques and methods of Utilization review/management, discharge planning or case management.
- Working knowledge of regulatory requirements and accreditation standards (TJC, Medicare, Medi-Cal, etc.).
- Demonstrated ability to utilize written and verbal communication, interpersonal, critical thinking and problem-solving skills.
- Demonstrated ability in planning, organizing, conflict resolution and negotiating skills.
- Computer literacy skills required.
Pay
Pay Range: $77.69 - $95.08 per hour.
Schedule
Scheduled Weekly Hours: 1; Shift: Day; Workdays: Mon, Tue, Wed, Thu, Fri, Sat, Sun; Working Hours: 08:00 AM – 04:30 PM; Job Schedule: Per Diem; Job Type: Standard Worker; Location: Onsite; Employee Status: Regular; Employee Group/Union Affiliation: B21|AFSCME|SCNSC; Job Level: Individual Contributor; Department: Moreno Valley Hospital - Utilization Management - 0801.
We need to ensure we didn't repeat job title as heading. Not included.
We removed boilerplate like EEO, etc.
Check that we preserved all substantive information: The job summary we captured. Did we miss any piece? The job summary also includes "Must be able to work collaboratively with the Multidisciplinary team, multitask and in a fast pace environment." That's included in the summary paragraph? We included that in the summary? Let's include it.
Our summary paragraph: "Works collaboratively with an MD to coordinate and screen for the appropriateness of admissions and Continued stays. Makes recommendations to the physicians for alternate levels of care when the patient does not meet the medical necessity for Inpatient hospitalization. Interacts with the family, patient and other disciplines to coordinate a safe and acceptable discharge plan. Functions as an indirect caregiver, patient advocate and manages patients in the most cost effective way without compromising quality. Transfers stable non-members to planned Health care facilities. Responsible for complying with AB 1203, Post Stabilization notification. Complies with other duties as described. Must be able to work collaboratively with the Multidisciplinary team, multitask and in a fast pace environment."
Yes.
Now responsibilities list: Did we include all? Let's double-check each sentence from the responsibilities block.
Original block after "Essential Responsibilities":
"Plans, develops, assesses and evaluates care provided to members.
Collaborates with physicians, other members of the multidisciplinary health care team and patient/family in the development, implementation and documentation of appropriate, individualized plans of care to ensure continuity, quality and appropriate resource use.
Recommends alternative levels of care and ensures compliance with federal, state and local requirements.
Assesses high risk patients in need of post-hospital care planning.
Develops and coordinates the implementation of a discharge plan to meet patients identified needs; communicates the plan to physicians, patient, family/caregivers, staff and appropriate community agencies.
Reviews, monitors, evaluates and coordinates the patients hospital stay to assure that all appropriate and essential services are delivered timely and efficiently.
Participates in the Bed Huddles and carries out recommendations congruent with the patients needs.
Coordinates the interdisciplinary approach to providing continuity of care, including Utilization management, Transfer coordination, Discharge planning, and obtaining all authorizations/approvals as needed for outside services for patients/famil
- for any list of duties/requirements/benefits. So we should convert each distinct duty into a
- . We need to preserve all substantive information. Let's parse the responsibilities sentences: "Plans, develops, assesses and evaluates care provided to members." "Collaborates with physicians, other members of the multidisciplinary health care team and patient/family in the development, implementation and documentation of appropriate, individualized plans of care to ensure continuity, quality and appropriate resource use." "Recommends alternative levels of care and ensures compliance with federal, state and local requirements." "Assesses high risk patients in need of post-hospital care planning." "Develops and coordinates the implementation of a discharge plan to meet patients identified needs; communicates the plan to physicians, patient, family/caregivers, staff and appropriate community agencies." "Reviews, monitors, evaluates and coordinates the patients hospital stay to assure that all appropriate and essential services are delivered timely and efficiently." "Participates in the Bed Huddles and carries out recommendations congruent with the patients needs." "Coordinates the interdisciplinary approach to providing continuity of care, including Utilization management, Transfer coordination, Discharge planning, and obtaining all authorizations/approvals as needed for outside services for patients/families." "Conducts daily clinical reviews for utilization/quality management activities based on guidelines/standards for patients in a variety of settings, including outpatient, emergency room, inpatient and non-KFH facilities." "Acts as a liaison between in-patient facility and referral facilities/agencies and provides case management to patients referred." "Refers patients to community resources to meet post hospital needs." "Coordinates transfer of patients to appropriate facilities; maintains and provides required documentation." "Adheres to internal and external regulatory and accreditation requirements and compliance guidelines including but not limited to: TJC, DHS, HCFA, CMS, DMHC, NCQA and DOL." "Educates members of the healthcare team concerning their roles and responsibilities in the discharge planning process and appropriate use of resources." "Provides patients with education to assist with their discharge and help them cope with psychological problems related to acute and chronic illness." "Per established protocols, reports any incidence of unusual occurrences related to quality, risk and/or patient safety which are identified during case review or other activities." "Reviews, analyses and identifies utilization patterns and trends, problems or inappropriate utilization of resources and participates in the collection and analysis of data for special studies, projects, planning, or for routine utilization monitoring activities." "Coordinates, participates and or facilitates care planning rounds and patient family conferences as needed." "Participates in committees, teams or other work projects/duties as assigned." That's a lot. We'll include them as
- .
Next, "Experience Basic Qualifications: Two (2) years combined RN experience in an acute care setting or case management required."
That's qualifications/experience. We'll have a
Requirements
maybe? The instruction says sections: About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. We need to decide where to put experience and education etc. Likely "Requirements" for basic qualifications (experience, license). "Qualifications" for preferred qualifications (education). "Skills" for skills like communication, critical thinking, computer literacy, etc. Let's extract: Experience: "Two (2) years combined RN experience in an acute care setting or case management required." Education: "Completion of an accredited RN training program that allows graduates to take RN license exam." License, Certification, Registration: "Registered Nurse License (California) Basic Life Support" Additional Requirements: list of demonstrated abilities: - "Demonstrated ability to utilize/apply the general and specialized principles, practices, techniques and methods of Utilization review/management, discharge planning or case management." - "Working knowledge of regulatory requirements and accreditation standards (TJC, Medicare, Medi-Cal, etc.)." - "Demonstrated ability to utilize written and verbal communication, interpersonal, critical thinking and problem-solving skills." - "Demonstrated ability in planning, organizing, conflict resolution and negotiating skills." - "Computer literacy skills required." Preferred Qualifications: "Bachelors degree in nursing or healthcare related field." Now we need to map to sections. We could have:Requirements
for experience, education, license, basic qualifications.Qualifications
for preferred qualifications (Bachelors degree).Skills
for the demonstrated abilities (communication, critical thinking, planning, organizing, conflict resolution, negotiating, computer literacy, utilization review knowledge, etc.) But we need to avoid duplication. Also we need to ensure we don't create sections with filler like "commensurate with experience". Not present. Pay: The posting includes "Pay Range: $77.69 - $95.08 / hour". That's specific pay info. So we should include aPay
with that info. Schedule: The posting includes "Scheduled Weekly Hours: 1 Shift: Day Workdays: Mon, Tue, Wed, Thu, Fri, Sat, Sun Working Hours Start: 08:00 AM Working Hours End: 04:30 PM Job Schedule: Per Diem Job Type: Standard Worker Location: Onsite Employee Status: Regular Employee Group/Union Affiliation: B21|AFSCME|SCNSC Job Level: Individual Contributor Department: Moreno Valley Hospital - Utilization Management - 0801". That's schedule info. So we can includeSchedule
with those details. Benefits: The posting mentions "Kaiser Permanente strives to offer a market competitive total rewards package and is committed to pay equity and transparency. The posted pay range is based on possible base salaries for the role and does not reflect the full value of our total rewards package." That's not specific benefits like health insurance, retirement, etc. It's generic. The instruction says: never create Pay/Schedule/Benefits sections unless the posting actually states them. For Benefits, we need specific benefits statements. The posting does not list specific benefits (like medical, dental, 401k). It only mentions total rewards package generically. That might be considered not specific enough. So we should NOT create a Benefits section. Now we need to output only HTML fragment, no /, no markdown. We'll produce:About the role
... (the job summary paragraph)
Responsibilities
- ... ...
Requirements
- Two (2) years combined RN experience in an acute care setting or case management required.
- Completion of an accredited RN training program that allows graduates to take RN license exam.
- Registered Nurse License (California) and Basic Life Support certification.
Qualifications
- Bachelor's degree in nursing or healthcare related field (preferred).
Skills
- Demonstrated ability to utilize/apply the general and specialized principles, practices, techniques and methods of Utilization review/management, discharge planning or case management.
- Working knowledge of regulatory requirements and accreditation standards (TJC, Medicare, Medi-Cal, etc.).
- Demonstrated ability to utilize written and verbal communication, interpersonal, critical thinking and problem-solving skills.
- Demonstrated ability in planning, organizing, conflict resolution and negotiating skills.
- Computer literacy skills required.
Pay
Pay Range: $77.69 - $95.08 per hour.
Schedule
Scheduled Weekly Hours: 1; Shift: Day; Workdays: Mon, Tue, Wed, Thu, Fri, Sat, Sun; Working Hours: 08:00 AM – 04:30 PM; Job Schedule: Per Diem; Job Type: Standard Worker; Location: Onsite; Employee Status: Regular; Employee Group/Union Affiliation: B21|AFSCME|SCNSC; Job Level: Individual Contributor; Department: Moreno Valley Hospital - Utilization Management - 0801.
We need to ensure we didn't repeat job title as heading. Not included. We removed boilerplate like EEO, etc. Check that we preserved all substantive information: The job summary we captured. Did we miss any piece? The job summary also includes "Must be able to work collaboratively with the Multidisciplinary team, multitask and in a fast pace environment." That's included in the summary paragraph? We included that in the summary? Let's include it. Our summary paragraph: "Works collaboratively with an MD to coordinate and screen for the appropriateness of admissions and Continued stays. Makes recommendations to the physicians for alternate levels of care when the patient does not meet the medical necessity for Inpatient hospitalization. Interacts with the family, patient and other disciplines to coordinate a safe and acceptable discharge plan. Functions as an indirect caregiver, patient advocate and manages patients in the most cost effective way without compromising quality. Transfers stable non-members to planned Health care facilities. Responsible for complying with AB 1203, Post Stabilization notification. Complies with other duties as described. Must be able to work collaboratively with the Multidisciplinary team, multitask and in a fast pace environment." Yes. Now responsibilities list: Did we include all? Let's double-check each sentence from the responsibilities block. Original block after "Essential Responsibilities": "Plans, develops, assesses and evaluates care provided to members. Collaborates with physicians, other members of the multidisciplinary health care team and patient/family in the development, implementation and documentation of appropriate, individualized plans of care to ensure continuity, quality and appropriate resource use. Recommends alternative levels of care and ensures compliance with federal, state and local requirements. Assesses high risk patients in need of post-hospital care planning. Develops and coordinates the implementation of a discharge plan to meet patients identified needs; communicates the plan to physicians, patient, family/caregivers, staff and appropriate community agencies. Reviews, monitors, evaluates and coordinates the patients hospital stay to assure that all appropriate and essential services are delivered timely and efficiently. Participates in the Bed Huddles and carries out recommendations congruent with the patients needs. Coordinates the interdisciplinary approach to providing continuity of care, including Utilization management, Transfer coordination, Discharge planning, and obtaining all authorizations/approvals as needed for outside services for patients/famil