Nurse Case Manager

Battelle•Norfolk, VA

85d•Hybrid

About The Position

The Health Research and Analytics (HRA) business line is seeking a highly motivated, full-time Nurse Case Manager to join our team in support of our government customer, U.S. Special Operations Command. This position will play a critical role in advancing the Preservation of the Forces and Family (POTFF) program, which is dedicated to optimizing and sustaining the mission readiness, longevity, and performance of Special Operations Forces (SOF). Through integrated and holistic human performance initiatives, POTFF strengthens both the Forces and their families, ensuring comprehensive support for those who serve. As a Nurse Case Manager, you will contribute to impactful research and analytics that drive evidence-based decision-making and enhance the effectiveness of these vital programs. This is an exciting opportunity to make a meaningful difference in the lives of SOF personnel and their families while working in a dynamic, mission-driven environment. This position applies professional health nursing principles and clinical expertise to analyze and address complex patient needs, ensuring appropriate and cost-effective treatment. This role involves collecting and communicating detailed health data, developing time-sensitive treatment plans, assessing patient care via telephone, and coordinating discharge planning to optimize care delivery and outcomes. Additionally, the Nurse Case Manager facilitates referrals, collaborates with healthcare providers, and manages service agreements to support efficient, effective, and compliant patient care.

Requirements

Certified as a case manager by a recognized certifying organization, i.e., Commission for Case Management Certification or American Nurse Credentialing Center
At least two years’ nursing experience
Current, full, active, and unrestricted license as a Registered Nurse in any U.S. State, the District of Columbia, Guam, Puerto Rico or U.S. Virgin Islands
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.
Experience effectively consulting with health care providers at all levels and negotiating with outside providers for services and products to obtain client services and support
Experience understanding diagnoses to assist patients to optimize their level of function and self-care
Possess 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
Maintain credentialing requirements in good standing at a local MTF
Possess 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.
Experience 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 to 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
Experience using research tools to critically evaluate existing practices, opportunities, and outcomes
Experience in management of information systems and technology to manage individual or population health, continuously improve practice, and effectively communicate practice outcomes to involved stakeholders
Knowledge of computers and software applications to conduct data collection, tracking, rending, and analysis
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

Nice To Haves

May be required to receive and maintain clinical practice privileges
Current certification in Basic Cardiac Life Support (BCLS) from the American Heart Association, with documentation provided
Ability to obtain and maintain a U.S. government security clearance

Responsibilities

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
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
Assess patient care via the telephone, using established protocols to provide appropriate and cost-effective care
Establish priorities for patient care monitors and evaluate progress toward the stated goals to provide coordinated, efficient, effective health care to its beneficiaries
Oversee discharge-planning activities to ensure ideal timing and sequencing of patient care
Provides professional assistance to health care finders to identify patient’s needs for referrals to appropriate health care providers or facilities
Negotiate, write, finalize, and administer product/service agreements to ensure mutual compliance in meeting care goals