Description: Job Summary:

Provides inpatient and intensive outpatient case management for high-risk, high-utilizing members with acute and/or chronic psychiatric conditions across the continuum of care. Develops treatment and care plans for the specific population.

Essential Responsibilities:

• Plans, develops, coordinates, assesses, and evaluates services provided to members to promote quality and cost effective outcomes.


• Develops and maintains case management policies and procedures to assure optimal and appropriate member utilization of services.


• Coordinates the interdisciplinary approach to providing continuity of care, including utilization management, transfer coordination, discharge planning, and obtaining all authorizations/approvals for outside services.


• Participates in the development of care paths.


• As an Intensive Case Manager coordinates the care of a large caseload of high risk patients and provides assessments and interventions in the community including in-home visits Consults with internal and external physicians, health care providers, discharge planning and outside agencies regarding continued care/treatment or hospitalization.


• Arranges and monitors follow-up appointments.


• Makes referrals to appropriate community services.


• Identifies and recommends opportunities for cost savings and quality of care improvements across the continuum.


• Develops and collects reports and data, and trends utilization of health care resources.


• Develops and presents in-service training and communication to both internal and external stakeholders.


• Interprets regulations, health plan benefits, policies, and procedures for members, physicians, medical office staff, contract providers, and outside agencies.


• Coordinates the transmission of clinical and benefit information and treatment to patients, families and outside agencies including issuing Non-Coverage and Denial of Benefits letters consistent with Health Plan Regulations.


• Acts as liaison to psychiatry clinics outside agencies, non-plan facilities, and outside providers.


• Coordinates repatriation of patients and monitors their quality of care. Provides administrative case management oversight to Inpatient Psychiatric Facilities, Crisis Residential Programs, and IMDs to ensure that services delivered to our members meet Kaisers Quality and Utilization expectations and guidelines.


• Provides administrative on-call to the RSR/Sub regional Office. Provides Clinical and Administrative documentation in accordance with Kaiser Regional Psychiatric Standards including the Inpatient/Integrated Urgent Services Guidelines.


• Kaiser Permanente conducts compensation reviews of positions on a routine basis. At any time, Kaiser Permanente reserves the right to reevaluate and change job descriptions, or to change such positions from salaried to hourly pay status. Such changes are generally implemented only after notice is given to affected employees.

Basic Qualifications:

Experience

• Minimum two (2) years of experience in an inpatient psychiatric setting or psychiatric emergency service.


• Minimum two (2) years of experience of care management or clinical experience.

Education

• Masters degree (Social Work or Psychology), or PhD (Psychology) required.

License, Certification, Registration

• Psychologist License (California) OR Licensed Clinical Social Worker (California) OR Licensed Marriage and Family Therapist (California)

• National Provider Identifier required at hire

Additional Requirements:

• Responsibility for a large caseload (50-100) for an extended period of time.


• Demonstrated expertise in crisis management.


• Demonstrated experience in utilization data collection and cost benefit analysis.


• Knowledge of TJC, and other local, state, and federal regulations.


• Must be able to work in a Labor Partnership Environment.

Preferred Qualifications:

• N/A

#LI-DP1

Primary Location: California,Santa Clara,Santa Clara Behavioral Health Center
Scheduled Weekly Hours: 1
Shift: Day
Workdays: Sun, Mon, Tue, Wed, Thu, Fri, Sat
Working Hours Start: 12:01 AM
Working Hours End: 11:59 PM
Job Schedule: Call-in/On-Call
Job Type: Standard
Worker Location: Onsite
Employee Status: Regular
Employee Group/Union Affiliation: NUE-NCAL-09|NUE|Non Union Employee
Job Level: Individual Contributor
Department: Santa Clara Behavioral Health - Psych -Closed Unit 1 - 0206
Pay Range: $53.84 - $69.64 / 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
On-site: Work location is on-site (KP designated office, medical office building or hospital). Worker location must align with Kaiser Permanente's Authorized States policy. 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

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