This position supports Kaiser Permanente's code of conduct and compliance by adhering to all laws and regulations, accreditation and Licensure requirements, and internal policies and procedures. Kaiser Permanente is proud to be an equal opportunity/affirmative action employer.
DEPARTMENT: Chief Operating Office
SCHEDULE: Full-time regular, 40 hours a week, Day shift, days and hours dependant upon departmental needs.
Education/License/Certification: BSN or BA in health care related field required. Masters degree preferred. Graduate of accredited school of nursing. Current California RN license required. CPR certificate required.
Position Summary: Manages various Continuing Care departments as assigned, which may include 24-hour and multiple location departments. Plans, organizes, directs, evaluates and coordinates inpatient nursing services and/or integrated outpatient- inpatient nursing services across the continuum of care within a Service Area or within a single medical center. Oversees utilization in Continuing Care Programs. Partners with the hospital on discharge planning and social issues. Coordinates with TPMG and appropriate hospital staff to provide for the seamless transition of patients across the continuum of care. Works with KFHP/H and the Medical Group staff developing strategic plans, providing quality care, cost effective services which are aligned with federal, state, and local regulations. Represents Health Plan for Hospital operations and the Continuum. Acts in role of Continuum Administrator in absence of Continuum Administrator.
Qualifications: Substantial experience in-patient care (usually 8 years). Progressive management experience required (usually 5 years). Demonstrated knowledge of Knox, Keene Act, Federal HMO Act, Nurse Practice Act, The Joint Commission, and all other local, state, and federal regulations. Demonstrated strong interpersonal communication skills.
Duties: Directs development and implementation of quality and utilization standards across the continuum of care to ensure coordinated plans of treatment, customer focused delivery of services, and cost effective utilization of necessary services. Ensures compliance with administrative, legal and regulatory requirements of the Health Plan contract and governmental and accrediting agencies. Oversees the development of department standards as identified by regulatory agencies, including The Joint Commission, NCQA, CMS, DHS and DMHC. Maintains a state of continuous regulatory readiness. Manages risk not only in the KP internal environment but external to Kaiser through the credentialing process, and quality process. Collaborates with other Service Directors in identifying and implementing innovative models and best practices, emphasizing service improvements and cost reductions. Develops services that achieve a high level of customer satisfaction with emphasis on customer service and highest standards of quality and innovation. Utilizes research data to implement clinical changes and the delivery of patient care and member services across the Continuum. Evaluates processes and makes recommendations to improve resource management systems and patient care outcomes across the continuum. Partners with hospital on discharge planning and social issues. Coordinates with TPMG to provide for seamless transition of patients across the continuum of care. Partners with Service Area KFH/TPMG administrative Leadership, APIC and Chiefs of Outside Services and Continuing Care Chief, Resource Management Chiefs, HBS chiefs, other KFH and TPMG service leaders/directors, managers across the continuum of care. Participates in region wide peer group and leadership activities to drive consistency of operations and performance improvement. Manages and resolves human resource, labor relations, employee, and department safety and risk management issues. Oversees utilization for assigned areas. Develops and manages systems and relationships with outside vendors; contract and quality oversight with external vendors. Develops budget and resource allocations for areas of responsibilities. Manages the financial performance and identifies and implements appropriate strategies to reduce costs and improve quality of care and services. Focuses on prevention/intervention and identification if issues/problems prior to their impact on operations and patient care; recommends and develops new programs for specialized patient populations to improve quality and effect improved utilization of services. Monitors utilization indicators; identifies and escalates programs; and initiates and evaluates action plans for achieving the area's utilization goals/targets. Consistently supports compliance and the Principles of Responsibility (Kaiser Permanente's Code of Conduct) by maintaining the privacy and confidentiality of information, protecting the assets of the organization, acting with ethics and integrity, reporting noncompliance, and adhering to applicable federal, state and local laws and regulations, accreditation and licenser requirements (if applicable), and Kaiser Permanente's policies and procedures. Kaiser Permanente conducts compensation reviews of positions on a routine basis. At any time, Kaiser Permanente reserves the right to reevaluate and change job descptions, or to change such positions from salaried to hourly pay status. Such changes are generally implemented only after notice is given to affected employees. In addition to defined technical requirements, accountable for consistently demonstrating service behaviors and principles defined by the Kaiser Permanente Service Quality Credo, the KP Mission as well as specific departmental/organizational initiatives. Also accountable for consistently demonstrating the knowledge, skills, abilities, and behaviors necessary to provide superior and culturally sensitive service to each other, to our members, and to purchasers, contracted providers and vendors.
PLEASE NOTE: - Kaiser Permanente is an AA/EEO employer -
