Registered Nurse Case Manager

About the job Registered Nurse Case Manager

ERP International is seeking Registered Nurse (RN) Case Managers for full-time positions in support of the Naval Health Clinic Lemoore, CA.

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 be named a 2024 Top Workplace by The Washington Post! 5 Years Running

• * Medical/Dental/Vision, STD, LTD and Life Insurance, 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, 8.5 or 9 hours between 7:30am and 5:30pm, to include a lunch breakNo Weekends, No HolidaysNo Call, No Call-Back

Job Specific Position Duties: The duties include, but are not limited to the following:

CORE Duties:

• Participate in all phases of the Case Management Program (CMP) and ensure that the CMP meets established case management (CM) standards of care.
• Provide nursing expertise about the CM process, including assessment, planning, implementation, coordination, and monitoring. Identify opportunities for CM and identify and integrate local CM processes.
• Develop and implement local strategies using inpatient, outpatient, onsite and telephonic CM
• Develop and implement tools to support case management, such as those used for patient identification and patient assessment, clinical practice guidelines, algorithms, CM software, and databases for community resources.
• Integrate CM and utilization management (UM) and integrating nursing case management with social work case management.
• Maintain liaison with appropriate community agencies and organizations.
• Accurately collect and document patient care data.
• Develop treatment plans including preventive, therapeutic, rehabilitative, psychosocial, and clinical interventions to ensure continuity of care toward the goal of optimal wellness.
• Establish mechanisms to ensure proper implementation of patient treatment plan and follow-up post discharge in ambulatory and community health care settings.
• Provide appropriate health care instruction to patient and/or caregivers based on identified learning needs.

• Maintain adherence to Joint Commission, URAC, Case Management Society of America (CMSA), and other regulatory requirements. Apply medical care criteria (e.g., InterQual).
• Provide input on MTF CM resources and make recommendations to the Command as to how those resources can best be utilized.
• Work in conjunction with the entire healthcare team and other departments, to identify high-risk and/or high-utilizer populations to include but not limited to those beneficiaries with multiple providers, multiple admissions/readmissions, Emergency Department visits, catastrophic illness, chronic or terminal illness, and multiple medical problems/dual diagnoses.
• Provide case management advice and consultation.
• Collaborate with other members of the healthcare team, the patient and/family/support system on a regular basis to establish and update the case management plan of care using evidenced-based guidelines (when available and/or applicable).
• Identify measurable short-and long-term goals/outcomes of care with matching strategies to achieve optimal wellness and autonomy (self- management). Incorporate the patient's cultural background, values and beliefs, readiness to learn and healthcare needs across the continuum of care into the plan.
• Provide the patient/ family with the knowledge and skills necessary for the implementation of the established plan. Facilitate patient and family decision-making activities by keeping them well informed of their rights, responsibilities and options. When indicated, follow patients through hospitalization and follows up in ambulatory and community health care settings.
• Actively measure the patient's response to the evidence-based plan of care and provide documentation that the plan and the quality of the services offered to the patient correspond to the identified needs.
• Ensure appropriate health care instruction to patient and/or caregivers based on identified learning needs.
• Facilitate multidisciplinary discharge planning and other professional staff meetings as indicated for complex patient cases and develop a database and knowledge of local community resources.
• Develop and implement mechanisms to evaluate the patient, family and provider satisfaction and use of resources and services in a quality-conscious, cost-effective manner.
• Collaborate with the multidisciplinary team members to set patient-specific goals. Develop treatment plans including preventive, therapeutic, rehabilitative, psychosocial, and clinical interventions to ensure continuity of care toward the goal of optimal wellness.
• Close cases when goals are met, patient declines service, patient transitions to another case manager or patient needs are no longer identified.
• Provide case management orientation and education for other case managers new to the role and/or facility providing scientific and practice-based knowledge per the Case Manager Core Competencies.
• Provide support to other case managers, including managing caseloads during absences.
• Facilitate and coordinate strategies to ensure smooth transition and continued health care treatment for patients when the military member transfers out of the area. Develop a policy for, and assist with, region-to-region transfers. This shall include coordination of required tests, procedures, treatments, discharge planning, community referrals, and transfers.
• Facilitate screening and assist with transfers of Exceptional Family Member Program (EFMP) families and service members going through the Integrated Disability and Evaluation System (IDES).
• Plan for professional growth and development as related to the case manager position and maintenance of CM certification. Actively participate in professional organizations including participation in at least one annual national CM conference to be funded by the government to be scheduled at the convenience of the government and the HCW. Ensure all training completion documentation is submitted to the region and HQ, as required.
• Participate in video teleconferences (VTCs) and other meetings as required.
• Provide safe, quality clinical case management services to a variety of eligible beneficiaries, in accordance with the Department of Defense (DoD), BUMED, Regional, directorate, and departmental instructions, policies and procedures.
• Keep informed of research and new information that will ensure new methods and practices are incorporated into the case management program; attends continuing education programs, seminars, and conferences in order to maintain core competencies in case management.
• Facilitate command cost containment through proper utilization of available resources and timely assessment of patient response to the case management program.
• Assist in the design, implementation, sustainment and ongoing improvement of the case management program.
• Increase MTF staff involvement in and support of case management initiatives by providing orientation and ongoing education and in-service training specific to case management and the program.
• Perform clinical assessments of the patients and managed care records that include clinical input from various health care providers across all clinical areas.
• Evaluate and treat outpatients and inpatients using laboratory and clinical findings and differentiate between contributory causes.
• Perform follow up clinical assessments to ensure the effectiveness of treatment plans in place.
• Perform all charting on the computer, utilizing various programs.
• Integrate case management with utilization management and disease management as needed.

Minimum Qualifications:

• * Education: BSN
• * Experience: Minimum 1 year experience as a RN Case Manager within the last 3 years
• * License: Active, unrestricted RN license
• * Board Certification: Must possess a case management related certification (CCM, CDMS, CRRN, COHN, COHNJ-S, ACCC, CRC, RN-NCM, or CMC)
• * Life Support Certifications: BLS
• * Security: Must be able to pass a Government background check and obtain a Government security clearance.

Pay Scale: $50/hr to $60/hr, to be determined based on employment options, qualifications, experience, and location