RN-Case Management

ERP International is seeking Registered Nurse (RN) Case Managers for full-time positions in support of the Mike O'Callaghan Military Medical Center, Nellis AFB, NV. Apply online today and discover more about this outstanding employment opportunity.  www.erpinternational.com

Be the Best!  Join our team of exceptional health care professionals across the nation. Come discover the immense pride and job satisfaction ERP Employees experience in providing care for our Military Members, their Families and Retired Military Veterans!  ERP International is honored to have been named one of The Washington Post’s 2024 Top Workplaces!

* Excellent Compensation & Exceptional Comprehensive Benefits!
* Paid Vacation, Paid Sick Time, Plus 11 Paid Federal Holidays! 

* Medical/Dental/Vision,  LTD/STD/Life and Health Savings Account available, and more!
* Annual CME Stipend and License/Certification Reimbursement!

* Matching 401K!

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 is an Equal Opportunity Employer - Disability and Veteran.

Work Schedule:

Monday - Friday, 8 to 10 hour shifts, between 7am and 6pm

No Call, No Weekends, No Holidays!

Job Specific Position Duties:

• Develops and implements a comprehensive Case Management plan/program in accordance with the facility’s goals and strategic objectives.
• Performs data/metrics collection on identified program areas; analyzes and trends results, including over- and under-utilization of healthcare resources. Identifies areas for improvement and cost containment. Reports case management patterns and provides feedback in a timely manner.
• Proactively identifies and evaluates patients and families for case management from a variety of resources 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 to include caring for those designated with diagnoses of wounded Warrior, Ill and Injured, TBI and PTSD.
• 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.
• 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.
• Verifies eligibility of beneficiaries using Defense Eligibility Enrollment Reporting System (DEERS). Obtains pertinent information from patients/callers and updates data in MHS Genesis, local referral database, and other office automation software programs as appropriate and directed.
• Interprets and evaluates data appropriately in collaboration with Health Care Integrator and Group Practice Manager.
• Documents and updates the treatment plan as needed in accordance with existing DoD, AF, local facility, and other agency guidelines. 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.
• Reviews referrals to case management for appropriateness, medical necessity, and if the needed service is a covered benefit according to appropriate health plan. If unsure, coordinates with TRICARE Regional Office Clinical Liaison Nurse or reviews TRICARE and Health Net Operations Manual.
• Receives and makes patient telephone calls, written, or e-mail correspondence regarding specialty clinic appointments and referrals following MTF-specific processes.
• Performs routine monitoring of referral management MHS GENESIS queue to ensure patients referrals are appointed and closed out.
• Monitoring and evaluation may include, but is not limited to: patients 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, DHA and local policies and guidelines.
• Travel outside of the local MTF and/or off the military installation may be necessary. When needed, travel to the patient's military living quarters during inspections to inspect and advocate for the patient's medical and special physical requirements and to verify that the housing being provided is safe, accessible, and facilitates the care and recovery of the member. Travel will be reimbursed IAW Para 2.4.1 of the Contract.
• Monitors active duty, reserve/guard admissions to civilian hospitals and via notifications from Referral Management as required.
• Serves as a liaison with headquarters, TRICARE and Health Net regional offices, MTF staff and professional organizations concerning Case Management practices.
• Collaborates with staff/departments, including, but not limited to: Executive Management, Resource Management, Medical Records, Patient Administration, Group Practice Managers, Health Care Integrators, Coders/Coding Auditors, Population Health Nurse Consultants, Medical Management, Referral Management, TRICARE Operations, patient care teams, Quality Improvement, and the Managed Care Support Contractors.
• Collaborates with Recovery Care Coordinator on the status of those enrolled in the Wounded Warrior Program.
• Coordinates and participates in interdisciplinary team meetings, designated facility meetings, and Care Coordination meetings. Shares knowledge and experiences gained from own clinical 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. Provides relevant and timely information to these groups, and assists with decision-making and process improvement. Participates in customer service initiatives, performance and quality improvement measures and medical readiness activities designed to enhance health services.
• 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); CAMH; (AAAHC); Health Services Inspection (HSI); and other applicable DoD and Service specific guidance and policies. Must also comply with the Equal Employment Opportunity (EEO) Program, infection control and safety policies and procedures.
• Follows applicable local MTF/AF/DoD, DHA instructions, policies and guidelines.
• Completes medical record documentation and coding, and designated tracking logs and data reporting as required by local MTF/AF/DoD, DHA instructions, policies and guidance.
• Completes all required electronic medical record training, MTF-specific orientation and training programs, and any AF/DoD, DHA, AFMRA mandated Case Management training.
• Ensures a safe work environment, employee safe work habits and patient safety IAW regulatory agencies, infection control policies, and process improvement initiatives. Promote and contribute quality performance, performance improvement programs, nursing peer review and nursing practice in a setting that supports professional practice and sets a positive example; identify and deliver excellence in the delivery of nursing services and care to patients/residents; introduces and disseminates best practices in nursing services. Proactively identifies process issues that could lead to negative patient outcomes and participates in the appropriate safety reporting processes for the facility.
• Attends AMRO (Airmen Medical Readiness Optimization) meetings, in-patient huddles/rounds, clinic huddles to determine need for assessment of potential case management services.

Minimum Qualifications:

* Degree/Education: Baccalaureate of Science in Nursing degree or other population health-related fields from an accredited educational institution is required. Advanced degree in a health care discipline is highly desirable, a masters in community health is desirable. National certification in a related field (e.g. community health, ambulatory nursing, or occupational health, etc.) is recommended.
* Experience: Minimum of five years of experience as registered nurse with at least 12 months of experience in disease management within the last 24 months
o Experience in case management, condition management, discharge planning, utilization management, Telehealth, and performance improvement is preferred.
o Computer skills in data management, Microsoft Office Suite: Outlook, Word, Excel (pivot tables), Power Point, Publisher and Access are desirable.
o Strong background in inpatient and outpatient nursing specialties, ambulatory care nursing, prevention, health promotion, disease/condition management, case management, discharge planning, and clinical data analysis highly desirable.

* Licensure/Certification: Active, unrestricted Registered Nursing license to practice nursing in a State, District of Columbia, the Commonwealth of Puerto Rico, or a territory of the United States.  Certified Case Manager by Commission for Case Management (CCM) or American Nurses Credentialing Center (ANCC) in full time clinical case management with children, families, seniors, or groups preferred. -OR- can be certification eligible if a BSN with 2 years full-time case management experience in past 3 years. Must obtain certification within 1 year of starting contract

* Life Support Certification: BLS from American Red Cross or American Health Association.
* Security: Must possess ability to pass a Government background check/security clearance.