EPRP Nurse Coordinator - TEMPORARY POSITION
Company: Kaiser Permanente
Location: Paramount
Posted on: February 25, 2026
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Job Description:
Description: Job Summary: To provide a centrally located and
operated initiative for Kaiser Permanente (KP) Southern and
Northern California Regions designed to help control emergency
claims costs and maintain or improve quality of emergency care
received by Health Plan members at non -Kaiser Permanente
facilities nationwide. Will review for appropriateness situations,
where a Health Plan member is receiving care in an emergency
medical situations from community providers (in area and out of
area). Will be using emergency medicine/critical care clinical
experience and general guidelines, to determine whether to
conditionally approve or deny care by community providers or
whether to negotiate for lower level of care for the member or
whether to refer to the SCPMG/TPMG MD on duty for review or whether
to arrange transfer for medically stable members to a Kaiser
Permanente Facility or Kaiser Permanente Contract Facilities.
Essential Responsibilities: Prospective utilization review
activities by reviewing cases with community emergency physicians
and making decisions to conditionally approve or deny treatment and
/or transfer Health Plan members with emergency needs. Also direct
and assist members appropriately requiring urgent care level of
medical needs. Encouraging limited patient work-up where practical
to reduce out-of-plan expenditures and acting as a resource for the
Claims Administration Department. Arrange critical care transport
of critically ill/hemodynamically stable Health Plan members from
community facilities (in area and out of area) to Kaiser Permanente
Facilities for the Southern and Northern California Divisions.
Assess available information and make quick appropriate/effective
decisions regarding level of care required for Southern and
Northern California Health Plan members. Notification to Couc
/Outside Utilization Coordinators (Southern California Division)
/Case Managers (Northern California Division) regarding non plan
admissions of Health Plan members for medical issues/situations.
Assist in the development and implementation of policies and
procedures for the EPRP/Critical Care Transport Program. Identify
and report to the EPRP Quality Assurance Coordinator for submission
to the Southern and Northern California Divisions KP facility
QA/Risk Management Coordinators regarding quality and risk
management issues to effect favorable management of members thereby
increasing member satisfaction. Document interactions and identify
emergency medical claims to assure follow-through for the Claims
Administration Department personnel for the Southern and Northern
California Divisions. Assist as a liaison with all three Kaiser
Permanente entities, KP contract providers and external providers
to help ensure that members with high cost claims receive timely,
coordinated, high quality and cost effective care. Basic
Qualifications: Experience Two (2) years of nursing experience in
Emergency Care/Critical Care required. Education N/A License,
Certification, Registration Registered Nurse License (California)
Additional Requirements: Knowledge of computers, ability to utilize
various software as required. Excellent written and verbal skills.
Demonstrated ability to communicate effectively in an
understandable manner telephonically and in writing. Demonstrated
ability in planning, organizing, conflict resolution, negotiating
and interpersonal skills. Autonomous professional with minimal need
for direct supervision. Preferred Qualifications: One (1) year
Pediatric or Pediatric Critical Care experience or one (1) year
Level III Neontatal Critical Care experience. Bachelors degree in
nursing or healthcare related field preferred. Notes: No Benefits
May rotate to two additional assignments in ETAP and PTAC. Option
II This is a temporary position for approximately 90 days
Keywords: Kaiser Permanente, Perris , EPRP Nurse Coordinator - TEMPORARY POSITION, Healthcare , Paramount, California
