Member Care Services Associate-Quest Integration - Maui

Kaiser Permanente

Wailuku, HI

JOB DETAILS
SKILLS
Case Management, Child Protection/Welfare, Community Health, Customer Support/Service, Department of Health and Human Services, Developmental Disabilities, Durable Medical Equipment, Functional Analysis, Health Plan, Healthcare, Interpersonal Skills, Medical Record System, Organizational Skills, Patient Assessment, Philosophy, Presentation/Verbal Skills, Problem Solving Skills, Process Development, Protective Services, Registered Nurse (RN), Spreadsheets, Team Player, Word Processing
LOCATION
Wailuku, HI
POSTED
Today
Description:
Job Summary:

Provides case management services to Kaiser Permanente Quest Integration (QI) members and their families to help navigate personal, social, financial, and medical needs. Works with QI RN Manager to assign QI members (adults, seniors and children) with special health care needs to appropriate care manager(CM)/care coordinator(CC). Works with RN Manager to develop QI processes for successful care management integration. Coordinates monthly collaborative Care Rounds. Develops and implements tracking systems for QI processes including, but not limited to, QI Face to Face Health Functional Assessments (HFA), Early and Periodic Screening, Diagnosis and Treatment (EPDST) including CM/CC member follow-ups. Develops and implements QI care plan summary templates for KP EHR. Develops and implements a tool box for initial HFA and reassessments for CM/CC.
Essential Responsibilities:


  • Develops the QI care management tool box for initial and reassessment materials needed for a home visit. Develops QI check lists and implements them.

  • Receives and performs initial triage of paraprofessional. Assists with resource development. Networks with other community based services. Works closely with CM/CC for referral regarding Home Community Based Services (HCBS)/Durable Medical Equipment (DME), dental services, Social, Emotional, and Behavioral Difficulties (SEBD)/Severely Mentally Ill (SMI), Child Welfare Services, Adult Protection Services (APS), and Developmental Delayed (DD).

  • Provides member care services to Kaiser Permanente QI enrollees. Navigates services based on medical, social and psychosocial needs, educates members on QI program and offers assistance as needed.

  • Navigates transportation and housing needs for members and/or their families for medical services both Inter island and on the Mainland.

  • Works with RN manager to assign QI member caseloads to RN CM and LSW CC. Develops and implements a HFA tracking form for RN CM/LSW CC in home visits and follow-ups.

  • Interprets and explains services of Kaiser Permanente QI program to members and families. Acts as QI member and family advocate. Navigates the health care system and health care services available to our members. Acts as liaison to promote Kaiser philosophy and services. Confirms QI coverage to patients and service providers within Kaiser as needed.
Basic Qualifications:
Experience


  • Three (3) years community outreach in healthcare setting, or related experience.

Education

  • High school diploma or GED.
License, Certification, Registration
  • Driver's License (from any state) required at hire
Additional Requirements:

  • Demonstrated knowledge of and skill in adaptability, customer service, interpersonal relations, oral communication, problem solving, teamwork and written communication.
  • Demonstrated knowledge of and skill in word processing, spreadsheet and database PC applications.
Preferred Qualifications:

  • Trauma situation and CTN/Special Processes experience preferred.
  • Bachelors degree in health and human services, or related field.

About the Company

K

Kaiser Permanente

At Kaiser Permanente, we are relentless in our pursuit of excellence. Driven by our mission to provide the highest quality preventive medicine, we are committed to eliminating health care disparities, and to making lives better through innovation, technology, and research. Our desire to deliver the best possible care inspires us to promote wellness among our members, communities, and each other. It also fuels our belief that everyone — regardless of circumstance — deserves access to affordable care, which further drives our motivation to expand our reach. Founded nearly 80 years ago, our unique business model sets us apart — positioning us to drive improvements across the industry and around the world.
COMPANY SIZE
10,000 employees or more
INDUSTRY
Healthcare Services
FOUNDED
1945
WEBSITE
http://www.kp.org/careers