6 days old

Transplant Coordinator

Kaiser Permanente
Atlanta, GA 30305

Responsible for carrying out all activities needed to make a decision regarding Organ Transplantation & Transgender services. Assist the referring physician w/the coordination & timely completion of work-up/activities & referral of members seeking transgender services & transplantation services, coordination of regional approval process, & facilitation of communication w/the respective National Transplant Services (NTS) HUB staff & the Transgender Case Mrg. Eligibility & benefit reviews will be performed as necessary. Discharge planning, identification of patients for case management, quality improvement reviews, & communication w/inpatient care coordinators, Transitional care teams, medical office staff, case Mrgs, providers, member service, claims, Contracts & Benefit Appeals & Risk Management are responsibilities of the position.

Essential Functions:
- Reviews & coordinates all requests for transplant evaluation & transgender request from the initial request to approval/denial by the QRM review Physician. These are done based on specific selection criteria & established guidelines per policy & procedures relating to the transplant & transgender programs (sexual Reassignment). Requests for kidney transplant evaluations are 1st reviewed by the CKD program Nephrologists' before sending to the QRM Physician. Ensures referrals & reviews will be performed w/in the required timeframe & the outlined notification process of the results. Refers all cases that do not meet established criteria to the appropriate QRM review physician. Upon approval of the transplant evaluation & the transgender evaluation, coordinates w/the healthcare team & the NTS Transplant Coordinator & the Transgender Case Mrg in the appropriate utilization of resources between the Center of Excellence (COE), the transgender provider & KPGA during all phases of transplantation & sexual reassignment. This includes eligibility, notification to member & referring MD. Performs concurrent review during hospital admission for Kidney transplant & assist w/documentation for other organ transplant & transgender services- related hospitalizations. Participates in scheduled teleconferences w/NTS HUB Transplant Coordinator & Medical Director to review status of members awaiting transplant or who have been transplanted. Also to discuss clinical course, discharge planning & potential QA/UM concerns of KPGA transplant members post-transplantation. Maintains effective interaction/communication w/transplant & transgender candidates & designee, HCT, Inpatient Care Coordinator/SNF Reviewer/General Review nurse/Complex Case Mrgs, Transition Case Mrgs, Social Workers, Referral Coordinators & other KPGA departments to facilitate the transplant & transgender process & ensure continuity of care & service. Continuously coordinates, monitors, tracks & evaluates all care & services rendered to ensure that quality care is being delivered in the most appropriate & cost effective setting. Acts as a resource to TSPMG practitioners, contracted consultants, Health Plan administrators & medical office staff as it relates to coordinating & facilitating the appropriate level of care & provision of services. Maintains contact w/patients & their families as appropriate, including the provision of education.
- Arranges, coordinates & facilitates appointments for the member as necessary.
- This job description is not all encompassing.


Posted: 2020-03-23 Expires: 2020-04-26

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Transplant Coordinator

Kaiser Permanente
Atlanta, GA 30305

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