Nurse Case Manager

Job Description

Job Description

Description:

THIS POSITION REQUIRES THE ABILITY TO OBTAIN AND MAINTAIN A SECRET CLEARANCE.

*Must Provide a Full range of professional health nursing principles, practices, and procedures in a clinical setting in order to analyze the full scope of problems associated with providing appropriate, cost effective care to the Department of Defense (DoD) beneficiaries.

• Oral and written communication skills in order to meaningfully interact with peers, outside agencies, vendors, providers, and Military Health System (MHS) stakeholders to exchange information, provide briefings, presentations, research, and metrics to demonstrate or advance effective, efficient case management practice, outcomes, and organizational/MHS value.
• Skill in team coordination, facilitation, and communication in order to facilitate the exchange of information/education, enhance goal achievement; augment abilities of client support network, and effect change in system or policy at any level.
• Knowledge of local, state, and federal laws and regulations, professional code of ethics, and practice standards in order to ensure adherence within legal and professional parameters.
• Knowledge and skill in using pre-established utilization review criteria recognize and report actual or potential quality and risk management issues in order to improve practice and ensure compliance.
• Knowledge and skill in the use of VA/DOD Clinical Practice Guidelines in order to ensure an evidence-based standardized process of care to military beneficiaries.
• Knowledge of the healthcare financial environment and the fiscal dimension of population health in order to ensure optimal stewardship of resources.
• Skill in use of research tools in order to critically evaluate existing practices, opportunities, and outcomes.
• Skill in management of information systems and technology in order to manage individual or population health, continuously improve practice, and effectively communicate practice outcomes to involved stakeholders.
• Knowledge of computers and software applications in order to conduct data collection, tracking, rending, and analysis. Ability to design and present computer-generated outcome analysis information in order to provide timely, effective peer and higher-level educational programs or project briefings.
• Knowledge of pharmaceuticals, their desired effects, side effects, and complications of their use in order to gauge their effect on patients and their recovery.
• Knowledge of community resources, patient entitlement/benefit eligibility, and ability to access these resources in order to assist patients/families in optimizing their level of function and self-care.
• Knowledge of current third-party regulations and policies, with special emphasis on TRICARE and Medicare benefits and services, in order to identify alternative financing sources to which DOD beneficiaries may be entitled.

Licenses/Certifications/Registrations

• Bachelor's degree in nursing (RN)/Minimum of two years nursing experience
• Certified as a case manager by a recognized certifying organization, i.e. Commission for Case Management Certification or the American Nurse Credentialing Center.
• Current, full, active, and unrestricted license as a Registered Nurse in any one of any U.S. State, the District of Columbia, Guam, Puerto Rico or U.S. Virgin Islands.
• Must maintain current certification in Basic Cardiac Life Support (BCLS) as certified by the American Heart Association.
• May be required to receive and maintain clinical practice privileges.
• Must maintain credentials requirements in good standing at a local MTF.

Working Conditions:
This job operates in a clinical environment that may involve bending, stooping, stretching, kneeling, standing and lifting occasionally.

The duties described in this position description in no way state or imply that these are the only duties performed. The candidate may be required to perform other duties as assigned by management.

IHA is an equal-opportunity employer. All qualified applicants will receive consideration for employment without regard to race, creed, sex, religion, national origin, disability status, protected veteran status, or any other characteristic protected by law. IHA is a Drug-Free Workplace employer