Continuing Care Utilization Review Coordinator RN (Bilingual Spanish)

March 11, 2026

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div bJob Summary:/b/div pConducts utilization review for in-house patients and/or those members at contracted facilities. Assists in the discharge planning process./pdivbrbEssential Responsibilities:/b/div ulliConducts utilization review for in-house patients and/or members who have been admitted to contracted facilities. Interviews patients/caregivers regarding care after hospitalization./liliConducts clinical reviews based on established treatment criteria./liliCollaborates with physicians on clinical reviews, keeps them appraised of Kaiser clinical criteria./liliReviews utilization patterns, identifies trends and problems areas for special studies./liliAssists in collecting and assimilating clinical data to enhance the quality of services./liliGenerates quality improvement results./liliReports and investigates unusual occurrences and questions inappropriate decisions based on their professional expertise./liliAssists other health care providers in the discharge planning process and triaging on alternative unit of care./liliCounsels on Medicare and health care plan coverage./liliCoordinates referrals to appropriate agencies/facilities./liliKaiser 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./li/ulbr divbBasic Qualifications:/b/div divuExperience/u/div ul liMinimum two (2) years of experience in an inpatient setting OR if for Skilled Nursing departments, minimum two (2) years of experience in a skilled nursing facility. /li liMinimum one (1) year of utilization experience required./li /ul divuEducation/u/div ul liBachelors degree in nursing or health related field required, OR four (4) years of experience in a directly related field./li liGraduate of accredited school of nursing./li liHigh School Diploma or General Education Development (GED) required./li /ul divuLicense, Certification, Registration/u/div ul liDriver's License (California)/li /ul ul liRegistered Nurse License (California)/li /ul ul liBasic Life Support/li /ul divbAdditional Requirements:/b/div ul liDemonstrated knowledge of diagnostic codes./li liMust be able to work in a Labor/Management Partnership environment./li liBilingual (Spanish) Level I required./li /ul divbPreferred Qualifications:/b/div ul liClinical expert in area of review preferred./li liMasters degree preferred./li /ul

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