Clinical Transplant Nurse I, Surgical Transplant Coordination (Santa Clara, Full Time)

Job Summary:

Essential Responsibilities:

• Promotes learning in others by proactively providing and/or developing information, resources, advice, and expertise with coworkers and members; builds relationships with cross-functional/external stakeholders and customers. Listens to, seeks, and addresses performance feedback; proactively provides actionable feedback to others and to managers. Pursues self-development; creates and executes plans to capitalize on strengths and develop weaknesses; leads by influencing others through technical explanations and examples and provides options and recommendations. Adopts new responsibilities; adapts to and learns from change, challenges, and feedback; demonstrates flexibility in approaches to work; champions change and helps others adapt to new tasks and processes. Facilitates team collaboration to support a business outcome.


• Completes work assignments autonomously and supports business-specific projects by applying expertise in subject area and business knowledge to generate creative solutions; encourages team members to adapt to and follow all procedures and policies. Collaborates cross-functionally and/or externally to achieve effective business decisions; provides recommendations and solves complex problems; escalates high-priority issues or risks, as appropriate; monitors progress and results. Supports the development of work plans to meet business priorities and deadlines; identifies resources to accomplish priorities and deadlines. Identifies, speaks up, and capitalizes on improvement opportunities across teams; uses influence to guide others and engages stakeholders to achieve appropriate solutions.


• Facilitating billing initiatives by: consulting with various departments on transplant claims questions by providing clinical insight under minimal guidance.


• Helps maintain relationships with programs of excellence by: collaborating independently with programs of excellence (POE) with the goal of providing total quality and case management for Kaiser Permanente (KP) members receiving transplant services; reviewing information forwarded to POEs, and requesting additional clinical information from POEs; and requesting communication of authorizations to the referring provider, POE, member, and/or claims unit.


• Supports compliance efforts by: proactively maintaining the privacy and confidentiality of information; protecting the assets of the organization; acting with ethics and integrity; reporting non compliance; and adhering to applicable federal/state/local laws and regulations, accreditation, and licensure requirements, and KP policies and procedures; and working within the scope of nursing practice and organization policies in the management of caseload assigned independently.


• Supports efforts to remain updated on current research, policies, and procedures by: managing the teams current knowledge in the field of transplantation and integrating this knowledge into the assessment of needs and problem solving required to manage across the continuum; updating education shared with members, families, physicians, POEs, and local providers regarding transplant services; and attending educational event and share with peers.


• Facilitating contract alignment by: ensuring contracts (e.g., within network or single case agreement) are established for Transplant services; leveraging knowledge of the terms of the contract to administer the terms as written; partnering with National Contracting Services to coordinate transplant logistics.


• Facilitates services related to coordination of care by: coordinating case management to include continuity of care, inpatient and outpatient care, utilization management,