Case Manager & Care Coordinator - Kailua Kona

About the Role

Provides case management and outreach services to selected patients, including discharge planning and follow-up for Health Plan members hospitalized at community hospitals. Incorporates Risk Management, Quality Management, and Utilization Management concepts into daily hospital and clinic activities.

Responsibilities

• Implements Continuing Care programs and initiatives with Continuing Care providers and PCP Team, making clinic/location-specific adaptations to ensure successful implementation. Monitors and evaluates outcomes.
• Provides case management services to targeted patients/families by interviewing and evaluating their needs, developing work plans, and coordinating resources to assure continuity and quality of care.
• Maintains working knowledge of community resources and interprets Kaiser Permanente benefits/services to patients, families, and community members.
• Monitors high-risk members and assists them with access to care, integrating patients into existing programs/services and evaluating outcomes.
• Assists patients/families with identified problems/concerns and coordinates community care to ensure quality, cost-efficient care.
• Makes daily hospital rounds for early identification of Utilization Management and discharge planning activities, assisting with discharge planning to facilitate smooth transfers.
• Reports Risk/Quality/Utilization Management issues to the Neighbor Island Management Team and acts as a contact person for MOA/Oahu discharges.
• Participates in community hospital interdisciplinary team meetings and maintains confidentiality of all patient information.
• May perform patient care to maintain clinical expertise, competency, and licensing necessary to fulfill job responsibilities.
• Develops and maintains collegial relationships with Government Programs office staff to meet regulatory requirements.
• Attends community seminars and workshops specific to professional needs and participates in approved educational programs.
• Assists in developing, implementing, maintaining, evaluating, and enhancing Total Quality Management activities within the organization.
• Incorporates the KP Nursing Vision, Model, and Values throughout nursing practice.

Requirements

• Minimum one (1) year of experience working with low-income/high-risk patients, preferably in a healthcare setting, including experience or training in the area of specialty.
• Bachelor’s degree in nursing OR four (4) years of experience in a directly related field.
• Registered Nurse License (Hawaii) required at hire.
• Basic Life Support certification from the American Heart Association.
• Case management/community outreach experience.
• Demonstrated knowledge and skill in oral/written communication, interpersonal relations, customer service, change management, multitasking, and problem-solving.
• Proficiency in word processing, spreadsheet, and database PC applications.

Preferred Qualifications

• Program development and operations-level implementation experience.
• Geriatric experience in an outpatient clinic setting.
• Supervisory or lead experience.

Pay

$121,500 - $157,190 / year

Schedule

• Full-time (40 hours per week).
• Shift: Day (flexible hours, including weekends).
• Travel: Yes, 75% of the time.