• Registered Nurse - Case Manager

    Job Locations US-NV-Nellis AFB
    Posted Date 2 months ago(5/2/2018 10:16 AM)
    Job ID
    2018-2370
    # of Openings
    1
    Category
    Clinical
  • Overview

    ERP International, LLC (www.erpinternational.com) is seeking an RN Case Manager for a full-time position to support the Wounded Warrior program at Mike O’Callaghan Federal Medical Center, Nellis Air Force Base, in Las Vegas, NV. Please apply online today to learn more about this great opportunity!

     

    About ERP International, LLC
    ERP is a nationally respected provider of health, science, and technology solutions supporting clients in the government and commercial sectors. We provide comprehensive enterprise information technology, strategic sourcing, and management solutions to DoD and federal civilian agencies in 40+ states. Founded in 2006, ERP is headquartered in Laurel, MD and maintains satellite offices in Montgomery, AL and San Antonio, TX - plus project locations nationwide.
     
    ERP offers exceptional benefits, including competitive compensation, Medical/Dental/Vision, short and long-term disability, life insurance, paid vacation, paid holidays, a matching 401(k), training and education opportunities, and semi-monthly direct deposit.

    Responsibilities

    Schedule:
    Monday – Friday: 7:30am – 4:30pm (40 hours/week)
    No Holidays/No Weekends
     
    Job Specific Details and Tasks:

    • Knowledge and ability to effectively apply the following core case management functions:
      • Assessment: Proactively identifies and evaluates patients and families for case management from a variety of sources such as discharge/disposition planning, referrals, the Medical Evaluation Board (MEB) process, the healthcare system, employers and facility staff. Conducts systematic, on-going, thorough collection of patient’s physical, emotional, psychological, social and medical status and information via direct patient contact and other relevant sources such as professional and non-professional caregivers, medical records, family/caregiver interviews.
      • Planning: Develops an appropriate patient-specific plan of care to include short and long term goals, objectives and actions. Coordinates, collaborates, and obtains approval of the plan among the patient, family/caregiver, primary provider and other members of the healthcare team.
      • Implementation: Guides the patient and family/care giver through the healthcare system, optimizing the use of appropriate resources. Coordinates and executes the plan of care, optimizing access to appropriate services. Ensures necessary referrals are ordered by the appropriate discipline and coordinated. Serves as an advocate for, and ensures education is provided to, the patient and family/caregiver as required. Promotes adherence to treatment plans for improved healthcare outcomes
      • Coordination: Ensures coordination of care delivery processes, to include alternate healthcare settings and the home environment, for the purposes of enhancing the patient's health and wellness, safety, productivity, and quality of life, and for providing the most beneficial, cost-effective health care. Develops, utilizes and maintains a variety of military and community resources to optimize access to services and medical care. Ensures timely and appropriate provision of services.
      • Monitoring: Documents and updates the treatment plan as needed in accordance with existing DoD, AF, local facility and other agency guidelines in the electronic health record data set (entitled AHLTA) and other approved electronic health records systems (to include ECCENTRIS). Maintains documentation and data collection in accordance with DoD, AF, local facility and other specified agency guidelines. Conducts and/or participates in program evaluation as directed.
      • Evaluation: Monitoring and evaluation may include, but is not limited to: patient’s adherence and response to the treatment plan; timeliness of patient and family/caregiver contact and follow-up; identification of variances, patterns or trends from established practice guidelines and/or standards; established outcome measurements; results of interventions, treatment delivery and timeliness of care; and utilization of resources. Monitors and evaluates the facility’s case management program per DoD, AF and local policies and guidelines.
      • Facilitation: Is to facilitate coordination and communication of care among all involved parties
      • Advocacy: Is to support the patient and family/caregivers to ensure identified education and appropriate, timely care is received; is to
      • Follow up: assess impact of plan and revision of plan as necessary.
    • Familiarity with Department of Defense (DoD), Federal, State, non-profit healthcare systems and organizations, to include DoD Tri-Service Military Healthcare Systems, TRICARE purchased care system, Medicare, Medicaid and the Veterans Administration (VA) is required. Knowledge of how to problem solve coverage through insurance and benefit conflicts is required when orientation is completed.
    • Experience with McKesson (InterQual) and/or Milliman Care Guidelines is desired. Is to have an awareness of what the TRICARE benefit consists of, and the limitations of the benefit. Is to advocate appropriate, indicated, evidence based, timely care within benefit limitations.
    • Knowledge of medical privacy and confidentiality (Health Insurance Portability and Accountability Act [HIPAA]) rules and regulations associated with HIPAA, and accreditation standards of Accreditation Association for Ambulatory Health Care (AAAHC) and The Joint Commission (TJC).
    • Must possess organization, problem-solving and communication skills to articulate medical requirements to patients, families/care givers, medical and nonmedical staff in a professional and courteous way.
    • Will have a working knowledge of computer applications/software to include internet familiarity is required. The ability to input, compile, analyze, extract and format data from established databases (including all military healthcare related databases) is required.
    • Must demonstrate ability to apply critical thinking skills and expertise in resolving complicated healthcare, social, interpersonal and financial patient situations.
    • Must demonstrate ability to communicate effectively both orally and in writing, with individuals as well as in small and large groups.
    • Must be skillful and tactful in communicating with people who may be physically or mentally ill, uncooperative, fearful, emotionally distraught, and angry.
    • Must be able to grasp and retain discharge planning/case management concepts quickly. As the patient population eligible for case management includes newborn to elderly, medicine, surgery and psychiatric conditions, as well as both inpatient and outpatient clients, and end of life issues the CM is to have a broad background in nursing. The CM is to have worked in nursing the past 12 months. Recent home health nursing experience is highly desirable.
    • Must maintain a level of productivity and quality consistent with: complexity of the assignment; facility policies and guidelines; established principles, ethics and standards of practice of professional nursing; the Case Management Society of America (CMSA); American Accreditation Healthcare Commission/Utilization Review Accreditation Commission (URAC); Manual used by The Joint Commission; the national inspection agency for ambulatory care facilities; Health Services Inspection (HSI); and other applicable Department of Defense (DoD) and Service specific guidance and policies. Must also comply with the Equal Employment Opportunity (EEO) Program, infection control and safety policies and procedures.
    • Completes all required electronic medical record training, MTF-specific orientation and training programs, and AF/DoD mandated Case Management training. Anticipates training which is tracked through the locally applied training database, and accomplishes training within whatever standard the military establishes. Maintains an up to date Competency Assessment Folder (CAF) at all times.
    • Completes all training within 30 days of assignment of new training. Keeps Competency Assessment Folder up to date with training. Avoids overdue training on HOPS. RN license and BLS training current.
    • Must be able to grasp and retain discharge planning/case management concepts quickly. As the patient population eligible for case management includes newborn to elderly, medicine, surgery and psychiatric conditions, as well as both inpatient and outpatient clients, and end of life issues the CM is to have a broad background in nursing. The CM is to have worked in nursing the past 12 months. Recent home health nursing experience is highly desirable.
    • Assists/tracks MEB to completion. Actively expedites all MEB activities to ensure congressionally mandated timelines are met.
    • Briefs service members undergoing MEBs on the process and the outcome of the MEB.
    • Adheres to HIPAA when communicating with military authorities.
    • Ensures Chief, Medical Management is aware of variances from normal operations. If Chief Medical Management is not available, ensures SGH is apprised of variances from normal operations.
    • Assists with tracking patients through on and off base medical services, including record retrieval. Cultivates contacts throughout the valley through which to obtain timely inpatient records on ADSM and patients of command interest. Obtains clinical information in a timely fashion when requested by MTF leadership.
    • Performs outreach to Active Duty Service Member (ADSM) by attending AF/VA meetings, held in the local area, sponsored by the VA that represent collaborative efforts
      to assist SM (Service Member) accessing both military and VA benefit programs. One example is the annual VA/Military Appreciation Day.
    • Work Environment/Physical Requirements. Requirements include prolonged walking, standing, sitting or bending, and computer use. The employee may be required to perform patient visitation at another medical treatment facility. The CM may be exposed to communicable diseases in the course of employment. Must be knowledgeable of and able to practice universal/standard precautions/infection control/isolation procedures and use appropriate Personal Protective Equipment (PPE) (provided by the employer) when patient condition warrants.
    • Represents the military and the TRICARE benefit in a positive/professional manner.
    • Participates in process improvement activities to include population health initiatives, record audits, reporting of variances from standard operations/sentinel events etc.
    • Coordinates and participates in interdisciplinary team meetings, designated facility meetings, and Care Coordination meetings. Shares knowledge and experiences gained from own clinical nursing practice and education relevant to nursing and case management.
    • Participates in the orientation, education and training of other staff. May serve on committees, work groups, and task forces at the facility. Accomplishes training deemed mandatory by the USAF/SG and or the consultant to the USAF/SG in Case Management.
    • Follows applicable local MTF/Air Force (AF)/DoD instructions, policies and guidelines. Attends teleconference calls when relevant to case management/the DES program.
    • Completes medical record documentation and coding, and designated tracking logs and data reporting as required by local MTF/AF/DoD instructions, policies and guidance.
    • Records hours worked through local personnel database every two weeks without prompting.
    • Coordinates the transfer of ADSM to the VA ensuring hand-off of care to the next care giver.
    • Must be able to perform tasks associated with tracking and reporting workload on a monthly or more frequent basis independently, without prompting.
    • Performs Facility Determination Inquiries (FDIs) in a complete/timely manner. Submits complete reports to the Chief of the Medical Staff (SGH) for conclusion about whether MTF/Las Vegas is able to provide care for the patient/family members.
    • Coaches ADSM in living the military lifestyle/accepting responsibility for recovery from illness and working to the individual’s full potential every day. Reinforces need to pass fitness test for those ADSM. Advocates for each ADSM to maintain the highest fitness standard achievable at all times. Promotes the achievement of military fitness standards.
    • Coordinates Integrated Disability Evaluation System (IDES) cases/Fast Tracks/Reports In Lieu Of (RILOS) with the administrative personnel working MEBs (PEBLOS) and VA personnel through to completion of the IDES process.
    • Actively participates in the Deployment Availability Working Group (DAWG)

    Qualifications

    Minimum Qualifications:

    • Minimum ASN, BSN preferred
    • Active/Unrestricted RN license from any state
    • Certified Case Manager (CM) preferred; if not certified when hired, must obtain certification within 24 months
    • Minimum 4 years of active nursing practice, of which at least 18 monthsmust be in discharge planning or clinical case management for adults, children, families, seniors or groups
    • Must be a U.S. Citizen and must be able to pass a government background check

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