Case Manager & Care Coordinator - Maui Lani

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 meets with Continuing Care providers and PCP Team to monitor targeted patients.
• Coordinates community care and explores options to assure quality, cost-efficient care is provided.
• 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 and written communication, interpersonal relations, customer service, change management, multitasking, and problem-solving.
• Demonstrated knowledge and skill 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

$97,200 - $125,752 / year. 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 the total rewards package. Actual base pay determined at offer will be based on labor market data, internal alignment, and a candidate's years of relevant work experience, education, certifications, skills, and geographic location.

Schedule

• Hours: 32 hours per week (part-time).
• Shift: Day shift.
• Workdays: Sun, Mon, Tue, Wed, Thu, Fri, Sat.
• Worker Location: Flexible (must align with Kaiser Permanente's Authorized States policy).