RN Team Lead, Home Health

Job Summary

To ensure coordination of care and services provided to all patients receiving home care services in the Home Health Program. Key functions are to develop a coordinated admission plan of care for patients referred; facilitate coordination of disciplines and services; use problem‑solving and critical thinking skills to facilitate, coordinate, and execute effective, timely responses to clinical problems as they arise for patients and home care clinicians;

and facilitate transitions across the continuum of healthcare settings for all home care patients.

• Referral and admissions to home care: evaluate home‑health referrals in collaboration with team members, ensure timely admissions, coordinate services and interventions, develop comprehensive admission plans, secure necessary supplies, and communicate service start‑dates.
• Optimize the patient home‑care plan by providing telephone advice/problem‑solving, after‑hours calls, support for staff, physician communication, scheduling of follow‑ups, staffing oversight, supply ordering, paneling patients with physicians, and facilitating care conferences.
• Coordinate, expedite, and track referrals and transitions across care settings, acting as an ambassador to care facilities and resolving barriers to safe transfers.
• Provide education and program development functions: maintain contact with hospital staff and KA departments, educate staff on transitions of care, assist with staff orientation, provide mentoring and coaching, participate in committees, ensure regulatory compliance, and conduct quality and utilization management activities.
• Conduct patient home visits as required to meet patient needs.
• Provide cross‑program coverage, participate in call duty, and perform other assigned duties.

• Minimum two (2) years home health experience as an RN.
• Minimum one (1) year leadership experience or commensurate experience.

• Bachelors degree in Nursing (BSN) or four (4) years of recent experience in a directly related field.
• High School Diploma or General Education Development (GED) required.

• Registered Nurse License (Washington) or Compact License:
  Registered Nurse.
• Registered Nurse License (Oregon).
• Drivers License (in location where applicable).
• Basic Life Support.

• Demonstrated ability to collaborate with physicians, ancillary providers, nurses, and patients to plan transitions of care.
• Triage/phone experience.
• Able to perform complete physical and psychosocial assessments.
• Able to operate stethoscope and sphygmomanometer.
• Keyboarding or typing skills.
• Able to operate a computer for clinical documentation.
• Highly effective problem‑solving, written and verbal communication, organizational, and time‑management skills.
• Knowledge of Medicare, The Joint Commission, and state requirements and regulations for home care programs.
• Knowledge of Kaiser Permanente systems.
• Position requires completion of a typing test.
• Position requires a reliable automobile to travel to and from patient homes.

• Minimum four (4) years experience as a registered nurse in acute care with at least one year in a Kaiser Permanente Home Care Program.
• Experience with care coordination or case management.
• Demonstrated customer‑focused service skills.
• Familiarity with computer use and keyboarding proficiency.
• Working knowledge of Medicare regulations for home care.
• OASIS‑C certification.
• Experience in oncology, rehabilitation nursing, or utilization management and care coordination.

• Shifts/days/working hours may vary.

Primary

Location:

Oregon, Portland, Kaiser Permanente Building

Scheduled Weekly

Hours:

40

Shift: Day

Workdays: Mon, Tue, Wed, Thu, Fri, Sat, Sun

Working Hours Start: 08:00 AM

Working Hours End: 04:30 PM

Job Schedule: Full‑time

Job Type: Standard

Worker

Location:

Flexible

Employee Status: Regular

Employee Group/Union Affiliation: W01|AFT|Local 5017

Job Level: Individual Contributor

Department: Kaiser Permanente Building - Home Health - 1008

Pay Range: $56.28 - $80.09 / hour

Kaiser Permanente strives to offer a market‑competitive total rewards package and is committed to pay equity and transparency. The posted pay range is based on possible base salaries for the role and does not reflect the full value of our total rewards package. Actual base pay will be determined at offer based on labor market data, internal alignment, and a candidate’s years of relevant work experience, education, certifications, skills, and geographic location.

Travel: Yes, 100 % of the time

Work Setting: Flexible

Worker location must align with Kaiser Permanente’s Authorized States policy.

Kaiser Permanente is an equal opportunity employer committed to fair, respectful, and inclusive workplaces. Applicants will be considered for employment without regard to race, religion, sex, age, national origin, disability, veteran status, or any other protected characteristic or status.