Coordinator, Community Medical Integration - Remote Position

Description: Job Summary:To assist NWP clinicians, KPNW members and community clinicians in the coordination of medical services between Kaiser Permanente and community providers and facilities. Includes interfacing with NWP clinicians, community providers and members to ensure the member receives high quality, safe, efficient and timely medical services.Essential Responsibilities:Preview and... preapprove requests for referral to community clinicians and/or programs for medically necessary services as requested by the NWP clinician.Work directly with the member and the community clinician to coordinate medical services within KPNW, providing accurate and timely information to the community physician and member related to requested services.Maintain knowledge base of resources available within the community and Kaiser Permanente assists with arranging for medical services in the appropriate location.With Community Medicine Integration Center leadership, insures compliance with regulatory and accrediting requirements for utilization of referred services, including NCQA, MDQR, Federal and State agencies.Maintains knowledge of Kaiser Permanente policies, procedures and benefits. Basic Qualifications:ExperienceMinimum two (2) years experience as a Registered Nurse.2 years prior health plan, authorization utilization management experienceEducationHigh School Diploma or General Education Development (GED) required.License, Certification, RegistrationThis 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 (Oregon) within 6 months of hireRegistered Nurse License (Washington) within 6 months of hireAdditional Requirements:Demonstrated customer focused service skills.Demonstrated ability to assimilate technical information.Ability to maintain effectiveness in a busy health care environment.Ability to work effectively with all medical staff.Ability to assess complex clinical management situations, synthesize data, develop and implement action plans.Ability to handle highly confidential and other information with discretion.Progressively responsible, broad based experience with health care management.Demonstrated skills negotiating and communicating with physicians and other health care providers to assist with the coordination of services to appropriate sites and levels of care.Working knowledge of computer systems and medical care delivery systems.2 years prior health plan, authorization utilization management experiencePreferred Qualifications:Minimum two (2) years of work experience as a Registered Nurse within Kaiser Permanente.2 years prior authorization or utilization management with a Health PlanExperience in inpatient and outpatient settings within Kaiser Permanente.Working knowledge of electronic clinical information systems, including HealthConnect and Results Reporting.Working knowledge of regulatory and accreditation requirements related to health care and health maintenance prehensive knowledge of Northwest Permanente and Kaiser Health Plan policies, procedures, personnel, goals, objectives, data systems and organizational structure.Bachelorsdegree in nursing or related field preferred. Primary Location: Oregon,Portland,Kaiser Permanente Building Scheduled Weekly Hours: 40 Shift: Day Workdays: Mon, Tue, Wed, Thu, Fri Working Hours Start: 08:00 AM Working Hours End: 05:00 PM Job Schedule: Full-time Job Type: Standard Employee Status: Regular Employee Group/Union Affiliation: NUE-NW-01NUENon Union Employee Job Level: Individual Contributor Department: Kaiser Permanente Building - OSM SVC ADMIN-DME - 1008 Pay Range: $102800 - $132990 / year The ranges posted above reflect the location in the job posting. The salary range may vary if you reside in a different location or state than the location posted. 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. Submit Interest Load More

Apply Job!