Remote Hybrid Case Manager Liaison Nurse – Must Live in Western WA

Primary Location Seattle, WA
Job Number 1195983
Date posted 06/20/2023

Description:

NOW is the time for you to join KPWAs Nursing Home Services (NHS) department as a Care Management Liaison Nurse (CMLN)!
As a NHS CMLN, you will assist to facilitate the benefits and utilization of KPWA members in Skilled Nursing Facilities (SNF). The CMLN is responsible for working closely with placement coordinators to choose an appropriate location for members to transition from the hospital to the SNF, with the Outcomes Manager to discuss medical needs of members, with nursing home care coordinators to gather member information, and with MD/ARNP/RN to ensure that members are treated in the appropriate post-acute care setting. The CMLN will be office-based out of a Kaiser Permanente Washington location
The CMLN is an advocate for our members as they transition through the continuum of care. They reviews notes, discuss Medicare skilled benefit criteria with the SNF team and providers to determine appropriate benefit coverage. The CMLN reviews patients referred to the SNF from various community settings to determine if SNF criteria is met and the appropriate health coverage. CMLNs assist in upholding member benefit stewardship.
Works closely with Kaiser Permanente Washington teams and network providers. Serves as the liaison across the internal Kaiser Permanente Washington care continuum regarding Nursing Home Services, and externally contracted providers, facilities. Monitors length of stay and patient appropriateness for continued stay in post-acute care/SNF setting. Works with the KP SNF physicians and practitioners in conjunction with the facility care teams, comprising of therapy departments , social workers, and nurses to make appropriate care decisions. Case management is a mix of telephone, virtual, and in-person meetings at facilities. Participate in quarterly leadership meetings with KPWA NHS, providers, and the SNF facilities. Provides education to SNF to improve care coordination, communication, and care management of KPWA members.

• • Oversee utilization of KPWA members while in SNF.

• • Work closely with KPWA and community providers to ensure excellent patient outcomes.

• • Assess members to ensure SNF criteria is met.