Job Description

Job Summary:

The Lead Onsight Inpatient Case Manager assists the Managers and Director in managing the overall operations of the Inpatient case management department for Kaiser Permanente Core Facilities in accordance with current Federal and State regulations and guidelines. The Lead Onsight Inpatient Case Manager works in collaboration with the Managers, Director, and Sr. Director of Inpatient Case Management to manage and implement the strategic plan for the Inpatient Case Management department as assigned. The Lead Onsight Inpatient Case Manager collaborates with the Hospitalists and CWD physician leaders. The Lead Onsight Inpatient Case Manager reports to the Manager of Inpatient Case Management. The Lead Onsight Inpatient Case Manager has frequent contact with the support staff, QRM staff, CWD physicians, Hospitalists, Core staff, Directors, Sr. Directors, contracted providers and community resources as well as contact with patients/families.

Essential Responsibilities:

• Effectively manages the activities of the care coordination team, providing leadership and guidance.



• Position has authority to recommend staffing plans, interview, recommend for hire, coach, and evaluate staff.



• Acts as a resource for onsite ICM team as well as physicians, health plan administrators, and contracted vendors.



• Will assist in problem solving for difficult cases.



• Works with Managers/Director/Sr. Director to identify department goals and objectives, develops and communicates action plans through regular staff meetings and other communications, uses team approach to problem solving and sets clear expectations.



• Works directly with staff to effectively move patients through the continuum of care through the hospital course and into post-acute settings, including monitoring, coaching, intervening, creative problem solving, removing barriers, and holding staff and self-accountable to proactive practice to manage the Length of Stay and ensure safe, appropriate comprehensive discharge plans are enacted.



• Collaborates with multiple providers in the care continuum to ensure optimal transitions of care, including but not limited to Skilled Nursing Facilities, Shelters, Home Health Agencies, Care Transitions Teams, etc., in efforts to reduce readmissions and improve patient outcomes.



• Works directly with staff to obtain and maintain proficiency in the Kaiser Permanente standard Utilization Management and discharge planning process, including teaching, coaching, monitoring outcomes, and continuing education.



• In collaboration with Manager of Quality Education and Compliance, identifies training needs and develops and participates in staff training and onboarding of new hires. Provides supportive environment and delegates appropriately.



• Seeks additional training opportunities through outside sources.



• Participates in on-call leader coverage as scheduled - provides after hours and weekend coverage of escalations, staffing needs, and day-to-day operations.



• May be designee for key operational meetings.



• Expected to float between core facilities based on business needs.



• Lead daily assignment or work schedule fluctuates with business needs.



• Run and management of reports as delegated by director.



• Demonstrate behaviors of a leader based on the Kaiser Permanente Vision.



• Participates as hands on team member.



• Maintains professional growth and development.

Basic Qualifications:

Experience

• Minimum two (2) years of experience in utilization management, case management, discharge planning in an acute care setting.



• Minimum two (2) years of current clinical nursing in an acute care setting.

Education

• Bachelors Degree in Nursing required.

License, Certification, Registration

• Registered Professional Nurse License (Georgia)
  

Additional Requirements:

• Knowledge of ACMA, CMSA, and NASW Standards of Practice.
• Knowledge of available health care and community resources.
• A broad knowledge base of health care delivery and case management within a managed care environment.
• Comprehensive knowledge of laws, regulations, and professional standards affecting case management practice in an integrated delivery system: including but not limited to CMS, Title 22, and Joint Commission.
• Strong critical thinking, problem resolution and time management abilities, and customer relation skills.
• Functional knowledge of computer systems.

Preferred Qualifications:

• Minimum two (2) years of supervisory/lead experience in UM/Case Management in a hospital case management/discharge planning environment.
• CCM/ANCC Certification or Board Certification equivalent preferred.
• Experience in planning, leading, and organizing the resources of a team preferred.
• Experience inpatient care or health education in a variety of settings is preferred.
• Leadership experience in acute case management is preferred.
• Masters in Nursing or Case Management preferred.

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