Kaiser Permanente Case Manager Occupational Health, RN in Anaheim, California

The OHS Case Manager guides, facilitates, and expedites the care and maximum recovery of patients and/or employees with work related injuries and illnesses. This consists of liaison work and communication between the patients and their employers and/or worker's compensation carriers and the medical staff and sub specialists. The OHS Case Manager is closely involved in organizing, assessing and communicating patient evaluation, treatment, continuity of care, follow-up, information regarding work status, need for further treatment, vocational rehabilitation and rehabilitation including guidance of patients and medical staff through the complexities of the workers' compensation system. The OHS Case Manager provides organized, efficient, and efficacious managed medical care to return injured patients to work as soon as medically and administratively possible.

Essential Responsibilities:

  • Assures that all OHS patients are case managed by: identifying the required level of case management and overseeing the deployment of the appropriate level of staff necessary to deliver service to the required level of management; development and implementation of an individualized case management plan and documentation of clinical resolution of care.

  • Manages all patients who have complex or catastrophic injuries by: monitoring and evaluating the treatment plan and identifying variances to the treating physician; assuring that the patient has access to care and moves through the OHS in an efficacious manner; monitoring, evaluating the achievement of patients' progress through comparison, guidelines and treatment plan and performing work site assessments when necessary.

  • Participates in the OHS Quality Management program by: data collection and analysis of clinical outcomes of care and customer satisfaction standards; participation on the OHS Practice Team in the formulation and implementation/monitoring of action strategies and outcomes of care or customer service.

  • Acts as a medical liaison between employers, carriers and third party administrators and injured workers by: communicating frequently (as indicated by the customers' standards) with employers, carriers, TPA's concerning work restrictions, treatment plans and progress, issues and problems and focusing on continually improving service and relationship.

  • Acts as a patient advocate and educator to assure that the patient has the knowledge to care for his/her injury and the patient is educated/empowered to be responsible for participating in the plan of care.

  • Participates as an OHS Management team member in decision making and execution of strategies to achieve the predetermined cost, quality, and service outcomes.

Basic Qualifications:

Experience

  • Minimum two (2) years of experience as a case manager in Occupational Medicine or related area including knowledge of workers' compensation and laws.

Education

  • Graduate of an accredited school of nursing required.

  • High School Diploma or General Education Development (GED) required.

License, Certification, Registration

  • Current and valid California RN license required.

Additional Requirements:

  • Demonstrated ability to utilize/apply the general and specialized principles, practices, techniques and methods of utilization review/management, care coordination, transfer coordination, discharge planning and case management.

  • Demonstrated ability to utilize written and verbal communication, interpersonal, critical thinking and problem-solving skills required.

  • Must be able to work in a Labor/Management Partnership environment.

Preferred Qualifications:

  • Bachelor's degree in nursing or healthcare related field (preferred) OR current equivalent related work experience (4) four years.

  • Certified Occupational Health Nurse, preferred.

Notes:

  • Required to float to other KPOJ/OHS departments when operationally needed.

  • Required to float to other KPOJ/OHS departments, same day, when operationally needed.

  • May work/provide services at employer health fairs.

  • Must have reliable transportation.

  • Once a month required to attend staff meeting starting at 7:00 am.

  • Participates as an OHS Management Team in creating, executing and oversight in clinical processes and procedures.

  • Completes monthly audits and OHSS validations for clinical staff.

  • Acts as a resource for all OHSS services and clinical guidance for staff.

  • Will attend training and become certified for all OHSS services performed in the department.

COMPANY: KAISER

TITLE: Case Manager Occupational Health, RN

LOCATION: Anaheim, California

REQNUMBER: 701544

External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran, or disability status.