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Case Manager Registered Nurse

Company: Katmai Government Services
Location: Colorado Springs
Posted on: June 20, 2022

Job Description:

Performs healthcare coordination and case management activities IAW Medical Treatment Facility (MTF) instructions.Essential Duties & Responsibilities

  • Ensures compliance with standards of care and practice (Accreditation Association for Joint Commission on Accreditation of Healthcare Organizations(JCAHO), Ambulatory Health Care (AAAHC) & Case Management Society of America (CMSA)).
  • Collaborates with military and civilian healthcare providers and staff and uses Utilization Management (UM) systems support to identify high-risk/high cost patients within MTF population.
  • Determines eligibility for healthcare coordination/case management services.
  • Coordinates with healthcare providers to ensure appropriate appointment alternatives, access and quality of care.
  • Coordinates services for eligible patients based on subjective and objective assessment data and identified patient/family needs.
  • Facilitates a multidisciplinary team to develop a treatment plan to address all identified conditions and problems. Integrates health education, promotion and prevention activities utilizing available MTF and local civilian condition/disease management resources. Participates in the orientation, training and evaluation of competency of newly assigned Case Management personnel.
  • Attends bi-weekly and as-needed multi-disciplinary discharge planning conferences within the MTF and as needed at the local treatment facilities.
  • Assists TRICARE eligible and Medicare-eligible patients in accessing local TRICARE and Medicare providers in conjunction with the MTF Referral Centers and the Central Referral Center.
  • Maintains current directories of local Medicare providers, suppliers, and Institutions.
  • Evaluates case management process utilizing defined parameters such as admissions, length of stay, level of care, Emergency Department/outpatient clinic visits and patient outcomes and institutes appropriate interventions.
  • Generates and maintains appropriate patient administrative records and provides upon request.
  • Reports monthly summary of care to Director, Medical Management (MM) or designee.
  • Conducts monthly evaluation, in conjunction with Primary Care Management (PCM) team, the benefit of case management. Closes case management cases when maximum patient benefit has been obtained.
  • Ensures a safe work environment and employee safe work habits.
  • Maintains regular and punctual attendance.
  • Other duties as assigned.Minimum Qualifications
    • Bachelor of Science Degree in Nursing (BSN) from a National League of Nursing (NLN) or American Academy College of Nursing (AACN) accredited college or university as delineated by Headquarters United States Air Force Surgeon General.
    • Minimum of three (3) years of documented medical or surgical experience and at least one (1) year experience in Case Management.
    • Possess a current, active, full and unrestricted Registered Nurses (RN) licensed in Colorado, be able to practice using a nurse compact state license, or have a license from any United States jurisdiction.
    • Must maintain a current, valid and unrestricted State nursing/social worker license in good standing.
    • Case Management certification desired.
    • Extensive knowledge of TRICARE, Medicare/Medicaid services and benefits is mandatory. Strongly preferred working knowledge of the military health care system as well as local community resources.
    • Demonstrates ability to prioritize, organize, problem-solve and coordinate daily activities to support effective improvement in individual patients.
    • Knowledge of professional care theories, principles, practices, and procedures to perform patient assessments with specific experience in the case management evaluation and assessment of pediatric, adult and geriatric patients as appropriate.
    • Demonstrates knowledge, skill and ability to use basic office automation and information management equipment and programs (i.e. word processing, database management, email, etc.).
    • RNs must have current Basic Cardiac Life Support (BCLS) certification from the American Red Cross. This certification shall be maintained in a current status at all times while performing services under this contract at no expense to the Government.
    • Must obtain and maintain the site's required health screening and immunization requirements.
    • Must obtain and maintain any necessary security access and/or background checks.
    • Must obtain and maintain all required documents, certifications, licenses, etc. listed on the credentialling checklist, sent by Katmai's Credentialing Specialist, for this position for initial hire.Special Skills
      • Experience in outpatient, home-health care, skilled nursing facility, hospice and mental health services are desired.
      • Experience with Medicare Eligible patients preferred.
      • Excellent patient assessment skills.
      • Excellent oral communication skills for patient education and telephone management of patients.
      • Sufficient initiative, interpersonal relationship skills and social sensitivity such that he/she can relate constructively to a variety of patients and healthcare staff from diverse backgrounds.
      • Ability to effectively read, write and speak English in order to communicate with all patients and other healthcare providers.
      • Ability to effectively communicate and collaborate with a diverse group of people for the purpose of informing the healthcare team of plans/actions, for teaching/education to benefit the patient/family and organization.
      • Excellent written communication skills to perform accurate documentation, both written and electronic, of all activity in accordance with requirements.ComplianceTo be considered for this position, all applicants must apply on the company website, https://katmaicorp.com/life-at-katmai/We are a VEVRAA Federal ContractorWe are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to age, race, color, religion, sex, sexual orientation, gender identity or national origin, disability status, protected veteran status, or any other characteristic protected by law. https://katmaicorp.com/life-at-katmai/#equal_opportunityPreference will be given to Ouzinkie Shareholders, Descendants of Shareholders and Spouses of Shareholders in accordance with Title 43 U.S. Code 1626(g) and Title 42 U.S. Code 2000e - 2(i).Executive Order 11246, as amended, protects applicants and employees from discrimination based on inquiring about, disclosing, or discussing their compensation or the compensation of other applicants or employees.

Keywords: Katmai Government Services, Colorado Springs , Case Manager Registered Nurse, Executive , Colorado Springs, Colorado

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