RN SNF Care Coordinator (FT, Days)
Beaverton, OregonAt Kaiser Permanente our nurses are leaders, clinicians, researchers, innovators, and scientists who are contributing toward being an industry-leading voice for advancing evidence-based care. Whether supporting the patient directly in our hospitals or clinics, providing care at home, serving our patients through innovative virtual technology, or managing care delivery teams, Kaiser Permanente nurses utilize scientific evidence and our integrated care model to optimize the total health of our members and the communities we serve. We invite nurses who are passionate about nursing excellence, high-quality compassionate care delivery, professionalism, integrity, teamwork and patient and family centeredness to join our teams so that we can continue to sustain and build upon our culture of excellence.
- Job Type: Part-time
- Job Level: Individual Contributor
- Travel: No
Success Profile
We’re looking for Nurse Leaders who possess the following traits.
- Collaborative
- Compassionate
- Flexible
- Leadership
- Socially Conscientious
- Trustworthy
Benefits
We offer several benefits to our nurses.
-
Medical, Vision & Dental
-
Retirement Plans
-
Educational Opportunities & Tuition Reimbursement
-
Supportive Teams & Resources
-
Career Growth & Development
Our Culture
At Kaiser Permanente, we cultivate an environment of compassion, integrity, trust, and open communication that helps our teams do their best work. We believe that lifelong learning will expand our knowledge so we can better serve our patients. Our practice is rooted in research and evidence-based care. Our nurses reflect the rich diversity of our members and communities and provide culturally responsive and competent care that promotes understanding of our members needs and preferences. At Kaiser Permanente, nurses are highly skilled professionals who exemplify leadership, critical thinking, and collaborative problem solving and deliver the right care, at the right time, in the right setting.
What Our People Are Saying
Kristen
Relief Charge Nurse
“Working as a nurse at Kaiser Permanente has allowed me the perfect flexible schedule so that I can volunteer as Girl Scout Leader and room parent for both my children. My kids know that I am a hardworking mother who can provide, as well as a mom who can be present and be there for them – and that means everything to me.”
Jazmin
RN, Advice Nurse
“Working for Kaiser Permanente has allowed me to take control of my future and make my goals a possibility. I feel that Kaiser Permanente allows me to keep climbing and moving. Having that ability truly makes me feel empowered.”
Stella
Registered Nurse IV
“Kaiser Permanente has taken me on a personal and educational growth journey. I am supported by a culture of excellence that allows me to be dedicated to patients and patients’ families every day at work. What an honor to be part of Kaiser Permanente.”.
Caitlin
Inpatient Lactation Consultant
“As an RN/IBCLC in Maternal Child, I’m meeting families at a pivotal time — I’m there to help launch a new family into the world. Everything I do has the potential to impact a family’s health for generations to come.”
Kimberly
Quality Coordinator RN
“In Hawaii, your community is your family — or ‘ohana.’ I am able to provide extraordinary patient-centered care to my ohana.”
David
Appointment and Advice RN
“The location is fantastic. Kaiser Permanente is all over the country. You can pick almost any environment you want – from ocean to mountain to city. You’ll still be able to contribute to our mission of providing high quality health care at a local facility.”
Shawn
BSN, RN
“I chose Kaiser Permanente because their staff and providers really show that they care about you. Also, throughout my 12 years of working here I’m always learning something new, and I’ve had many opportunities for growth and development.”
RN SNF Care Coordinator (FT, Days)
Primary Location Beaverton, Oregon
Worker Location Flexible
Job Number 1357021 Date posted 05/16/2025
Navigating the Hiring Process
We're here to support you!
Having trouble with your account or have questions on the hiring process?
Please visit the FAQ page on our website for assistance.
Need help with your computer and browser settings?
Please visit the Technical Information page for assistance or reach out to the web manager at kp-hires@kp.org.
Do you need a reasonable accommodation due to a disability?
A reasonable accommodation is any modification or adjustment that enables you to fully participate in completing the following:
- Online Submissions
- Pre-Hire Assessments
- Interview Process
Please submit your accommodation request and an HR Representative will contact you.
Description:
To optimize the efficiency, effectiveness and quality of clinical care provided by Kaiser Permanente clinicians and facility staff through the use of utilization, case/care management and customer service skills and techniques. To optimize patient/family satisfaction with care received in the SNF setting. To assure efficient and effective transitions of care from to and from the skilled and non-skilled SNF setting.
Job Summary:
To optimize the efficiency, effectiveness and quality of clinical care provided by Kaiser Permanente clinicians and facility staff through the use of utilization, case/care management and customer service skills and techniques. To optimize patient/family satisfaction with care received in the SNF setting. To assure efficient and effective transitions of care from to and from the skilled and non-skilled SNF setting.
Essential Responsibilities:
- Enhances the delivery of case/care management on a daily basis. Assists the Kaiser Permanente team to enhance -SNF quality at our contracted facilities. Partners with the facility and third party rehabilitation consultant to analyze quality outcome data using statistically valid methodologies and graphics. Negotiates performance improvement activities with facility management as a result of NaviHealth data as well as when care issues are present. Consults with facility management and SNF Operations Manager in setting annual quality improvement goals. Addresses high risk, high volume patient care activities through use of continuous quality improvement tools and techniques. Identifies, tracks, and trends adverse events. Identifies and reports significant events. Facilitates root cause analyses. Partners with facility administration in developing systems to improve clinical quality and patient safety. Assists with identifying significant knowledge deficits within care team and addresses them through partnership (Kaiser Permanente and facility). . Facilitates and interprets understanding and improvement of quarterly quality measures. . s. Identifies and evaluates opportunities for improvement in patient hand-offs between settings (hospital, ED, SNF, home care, etc). Identifies opportunities to reduce hospital readmissions both while the patient is in the SNF and immediately post SNF discharge. Works with quality and utilization personnel in these settings and programs to improve performance.
- Facilitates efficient care delivery. Supports Kaiser Permanente clinicians in organizing and efficiently providing patient/family care through a variety of means (e.g. gathering data, soliciting and organizing patient/family concerns and priorities, assuring efficient rounding). Participates in patient care conferences. . Assists interdisciplinary care team with the identification and development of care goals consistent with patient/family wishes, clinical prognosis and rehabilitation potential. Identifies barriers to achieving patient discharge and assists the care team in overcoming them on an individual patient and/or gaps in care population basis. Assists the care team in defining patient care goals that must be met in order for the patient to successfully transfer to a lower level of care. Collaborates with the facility team to identify and address patient resource needs (e.g. supplies, equipment, orthotics, transportation, etc) required to achieve desired clinical outcomes, patient safety and efficient care, both in the facility and in post discharge care setting. . Assure appropriate utilization of available resources and benefits. Coordinates activities of Kaiser Permanente clinical resources (e.g. outpatient visits, pharmacy, laboratory, imaging services) to assure timely, efficient and quality care. Facilitates interdisciplinary team meetings with facility and clinicians to align goals, explore options and plan effective and efficient care transitions.
- Interprets utilization criteria for patients both prior to and during a SNF admission using accessible clinical information, Medicare criteria and/or Milliman Care Guidelines. Provides consultation to clinicians regarding last covered day. Educates patient and family regarding utilization criteria and appeal rights. Provides notices of non-coverage notices to members that meet benefit and timeliness standards for Medicare and other regulatory compliance requirements. Facilitates completion of inter-rater reliability exercises. Assures consistent application of utilization criteria in compliance with regulations (NCQA, Medicare, etc). Provides utilization oversight of patients at non-contract and out of area facilities. Provide benefit interpretation for copayments and cost sharing.
- Works closely with community physicians and facilities in managing out of area patients to ensure efficient care delivery and appropriate utilization.
- Enhances customer service. Meets with patients and family members at the beginning of and throughout the SNF stay. Serves as a liaison between the patient/family and care team (facility staff, Kaiser clinicians and home caregivers). Researches patient/family care and service questions and concerns. Addresses patient/family complaints through timely, effective and culturally competent communication. Serves as a resource for complaint research and resolution and documents in complaint tracking system. Collaborates with team to assess patient and family care wishes related to end of life care. Collaborates with team to refer patients at end of life to hospice, palliative care and other community programs. Assures patients/families are aware of out of pocket costs associated with services.
- Maintains up-to-date clinical knowledge of geriatric and rehabilitation best practices. Maintains up-to-date knowledge of hospital, LTACH, SNF, home health, hospice and palliative care utilization criteria. Maintains up- to-date nursing knowledge of clinical pharmacology. Assesses knowledge deficits and provides both individual and group education in partnership with management and the clinical care team.
Basic Qualifications:
Experience
- Minimum two (2) years as a Case Manager/Care Coordinator.
- Minimum two (2) years of geriatric clinical practice in home health, hospice, hospital or long-term care setting.
Education
- BSN or bachelors degree in a health-care related field or currently enrolled in a BSN program, OR four (4) years of experience of case management or equivalent experience in a directly related field.
- High School Diploma or General Education Development (GED) required.
License, Certification, Registration
- This job requires credentials from multiple states. Credentials from the primary work state are required at hire. Additional Credentials from the secondary work state(s) are required post hire.
- Registered Nurse License (Washington) within 2 months of hire OR Compact License: Registered Nurse within 2 months of hire
- Registered Nurse License (Oregon) within 2 months of hire
- Drivers License (in location where applicable) required at hire
- Basic Life Support required at hire
Additional Requirements:
- Demonstrated ability to interrelate with physicians, nurses, support staff, and patients in interdisciplinary approach.
- Demonstrated ability to work as part of a team and work as a constant patient advocate.
- Basic physical, psychosocial, functional assessment skills.
- Familiar with care processes and systems in settings internal and external to Kaiser Permanente.
- Familiar with and able to collaborate with Kaiser Permanente and community resources.
- Ability to work with angry or hostile individuals in high pressure situations.
- Ability to effectively provide culturally competent care.
- Able to develop concise and thorough documentation of patient clinical assessment and care needs.
- Highly effective problem solving, written and verbal communication, customer service, organizational and time management skills.
- Familiarity with and ability to use computers.
- Ability to collect, analyze and report meaningful quality and utilization data.
- Working knowledge of admission criteria for SNF, Home Health, Hospice, Long Term Acute Care and Inpatient Rehabs.
Preferred Qualifications:
- Minimum two (2) years of previous utilization and quality management experience.
- Previous experience working in the long-term care setting.
- Bachelors degree in nursing.
- CPHQ certification in Health Care Quality Improvement or Certified Case Manager (CCM) or Certification in geriatric nursing.
- Knowledge of Medicare SNF criteria.
Primary Location: Oregon,Beaverton,Beaverton Medical/Dental Offices 4855 SW Western A
Scheduled Weekly Hours: 36
Shift: Day
Workdays: Mon, Tue, Wed, Thu, Fri, Sat, Sun
Working Hours Start: 08:00 AM
Working Hours End: 05:00 PM
Job Schedule: Part-time
Job Type: Standard
Worker Location: Flexible
Employee Status: Regular
Employee Group/Union Affiliation: W05|AFT|Local 5017
Job Level: Individual Contributor
Department: Kaiser Permanente Building - Qtly Rsrc-Long Term Care - 1008
Pay Range: $52.52 - $80.11 / 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
Flexible: Work location is on-site at a KP location, with the flexibility to work from home.
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 fair, respectful, and inclusive workplaces. Applicants will be considered for employment without regard to race, religion, sex, age, national origin, disability, veteran status, or any other protected characteristic or status. Submit Interest
Kaiser Permanente is an equal opportunity employer committed to fair, respectful, and inclusive workplaces. Applicants will be considered for employment without regard to race, religion, sex, age, national origin, disability, veteran status, or any other protected characteristic or status. Submit Interest
Industry Leader
Experience nursing excellence
At Kaiser Permanente our nurses are leaders, clinicians, researchers, innovators, scientists, and more. It takes an extraordinary team to offer extraordinary care.
Our Events
Meet a member of the Kaiser Permanente team at an upcoming career or professional event.