Kaiser Permanente·Clackamas, Oregon
The RN Care Coordinator manages patient transitions across care settings by assessing needs and developing comprehensive care plans. They serve as expert consultants to the healthcare team to ensure quality, cost-effective care and accurate utilization of resources.
Inpatient Care Managers are Registered Nurses who independently assure patients are admitted to the correct level of care for accurate billing and reimbursement, provide quality, cost effective clinical coordination/care management in acute care and emergency care settings, manage patients with routine and complex transition planning needs by independently assessing needs, developing, and implementing plans of care for transitions across care settings. Inpatient Care Manager also serve as expert consultants and educators for physicians and other health care team members for discharge and transitional care, coordination of internal and community resources, and support the evaluation and improvement of systems of care to support the optimal utilization of health care resources, while maintaining quality of patient care. The Inpatient Care Manager assumes primary accountability for anticipating, assessing, developing, implementing, documenting, advising, and communicating a safe transition plan of care for patients with complex care needs.
Coordinates post-discharge patient care needs to assure the timely and effective discharge of routine and complex patients from the hospital setting. Independently and proactively completes and documents patient assessments which are thorough, timely, age appropriate, and reflect psychosocial support systems, care needs, health plan benefits, level of care determinations for hospitalized patients. Coordinates and communicates with patients, families, and the health care team to develop mutually agreeable plans of care that optimize the use of resources to support the particular needs of individual patients. Facilitates resolution of issues which present barriers to safe transfers through the use of patient/team care conferences to assure the efficient transition to a lower level of care and to assure the patient/family receives the right care at the right time so that quality and utilization of resources are simultaneously enhanced. Ensures systematic and ongoing contact with interdisciplinary staff and continuing care services to assure the safe transition of patients across care settings. In collaboration with the interdisciplinary health care team, ensures regulatory and compliance standards are met. Perform duties as requested.
Knowledge of appropriate utilization of acute hospital and Kaiser Permanente internal resources. Knowledge of Medicare and Medicaid regulations related to eligibility requirements: hospital, nursing facilities, home health, hospice, and Durable Medical Equipment (DME). Knowledge of utilization management principles and tools. Demonstrated clinical judgment and customer-focused service skills. Knowledge of principles of patient teaching, disease prevention measures, and physical assessment as it relates to the needs of patient and the next level of care. Certified in Case Management. BSN or bachelors degree and MSN.
Candidates must have at least two years of acute care RN experience and a valid Registered Nurse license in Oregon and Washington. A high school diploma or GED is required, and additional certifications like Case Management are preferred.
Market context
In Oregon, nursing roles are typically in steady demand across hospitals, clinics, and long-term care settings, especially for candidates with acute-care experience and current licensure. These positions can be competitive because employers often look for an accredited nursing degree, an active RN license, BLS certification, and prior experience, with added value for those who can complete NIH Stroke Scale certification quickly. Review the AI-summarized requirements and benefits here to save research time, then confirm your license status and prepare examples of recent patient-care experience before applying.