Nurse Case Manager

Description

JES Tech is seeking an exceptional Nurse Case Manager, hereafter referred to as the Case Manager, to provide a full range of professional health nursing principles, practices, and procedures in clinical settings to analyze the full scope of problems associated with providing appropriate, cost effective care to Department of Defense (DOD) beneficiaries. This position supports the Preservation of the Force and Family Contract (POTFF) for the 1st Special Forces Command (1SFC).

DUTIES & RESPONSIBILITIES

• The Case Manager shall collect, organize, record, and communicate data relevant to primary health assessments including a detailed medical history to develop time sensitive treatment plans which delineate the expected process of care delivery for selected case managed patients or populations.
• The Case Manager shall assess patient via the telephone, using established protocols, to provide appropriate and cost-effective care.
• The Case Manager shall establish priorities for patient care monitor and evaluate progress toward the stated goals to provide coordinated, efficient, effective health care to its beneficiaries.
• The Case Manager shall oversee discharge-planning activities to ensure ideal timing and sequencing of patient care.
• The Case Manager provides professional assistance to health care finders to identify patient’s needs for referrals to appropriate health care providers or facilities.
• The Case Manager shall negotiate, write, finalize, and administer product/service agreements to ensure mutual compliance in meeting care goals.

Requirements

• Must have demonstrated skill in understanding diagnoses to assist patients to optimize their level of function and self-care.
• Shall possess demonstrated knowledge of patient education principles and management of complex medical, psychosocial, and financial problems to enhance patient adherence to individualized treatment plans and train peers and staff.
• Shall have a minimum of two (2) years nurse case management experience.
• Shall possess the ability to seek feedback from peers, professional colleagues, clients, and outcomes research, to expand clinical knowledge, enhance role performance, and increase knowledge of professional issues.
• Shall have the skills to effectively consult with health care providers at all levels and negotiate with outside providers for services and products to obtain client services and support. May be required to receive and maintain clinical practice privileges.
• Shall maintain credentialing requirements in good standing at a local Medical Treatment Facility (MTF).
• Shall be certified as a case manager by a recognized certifying organization, i.e., Commission for Case Management Certification or American Nurse Credentialing Center OR meet qualifications to obtain CCM certification within one (1) year of hire.
• Current, full, active, and unrestricted license as a Registered Nurse in one of any U.S. State, the District of Columbia, Guam, Puerto Rico, or U.S. Virgin Islands.
• Must have and maintain a current certification in Basic Cardiac Life Support (BCLS) as certified by the American Heart Association. (Documentation of such training shall be provided to the COR. The front and back of the BCLS shall be provided to the Credentialing Department of the MTF they are credentialed through.

Required Minimum Skills:

• Oral and written communication skills 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 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 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 to improve practice and ensure compliance.
• Knowledge and skills in the use of VA/DOD Clinical Practice Guidelines 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 to ensure optimal stewardship of resources.
• Skill in management of information systems and technology to manage individual or population health, continuously improve practice, and effectively communicate practice outcomes to involved stakeholders.
• Ability to design and present computer-generated outcome analysis information 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 to gauge their effect on patients and their recovery.
• Knowledge of community resources, patient entitlement/benefit eligibility, and ability to access these resources 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, to identify alternative financing sources to which DOD beneficiaries may be entitled.
  
  Salary Range: $85,000-90,000

www.jestechllc.com

Equal Opportunity Employer

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

U.S. Citizenship or US Permanent Residency and the ability to successfully obtain a Public Trust Security Clearance is required.