(Archived) Patient Care Coordinator MF

Utilization management using InterQual criteria and dischharge planning following Kaiser protocols. Performs daily pre-admission, admission, and concurrent utilization reviews to determine appropriate
levels of care and readiness for discharge. Escalates utilization and system problems which have not
been resolved immediately. Performs rounds and reviews patient admissions under Kaiser Skilled
Nursing Facility (SNF) benefit. Utilizes knowledge and experience of Medicare regulations and Health
Plan benefits to determine medical necessity. Monitors the progression of the plan of care and facilitates
discussions with the multidisciplinary teams. Educates other healthcare team members on utilization and
cost containment initiatives. Collaborates with and provides information to patients, families, physicians,
and staff regarding the provisions of care. Issues denial/notices of non-coverage letters after conferring
with physicians.

Equipment utilized in the unit/dept.
Computeized charting and notes. Delivery of some DME items.

Required skills and minimum years of experience.
Bachelor's degree in nursing; or four (4) years of directly related experience. Minimum two (2) years of experience in direct patient care delivery & management.

Specific licensures and certifications/registrations required.
Hawaii RN License. Active BLS - Must be AHA

Shift or schedule requirements.
M-F 0800-1700. Rotating weekends every other week. Some holidays

Floating to over units/departments.
None

Bed size/number of rooms for this unit/dept.
250 bed capacity. typically less than 15 case load

Nurse to patient ratio of this unit.
1:15 typically

Dress Code:
Business casual

13 week assignment