Registered Nurse - Case Manager

Join the 'Ohana•San Antonio, TX

6d•Remote

About The Position

This role involves providing clinical nursing, administrative, and organizational skills to manage the continuity of care for beneficiary populations supported through the Virtual Medical Center (VMC). The Registered Nurse - Case Manager will conduct comprehensive assessments of Active-Duty Service Members' health needs, develop care plans, and facilitate communication among healthcare teams. Responsibilities include educating patients and healthcare providers on case management, healthcare options, community resources, and insurance benefits. The role also involves problem-solving, encouraging appropriate healthcare service utilization, advocating for patients, and coordinating follow-up care. The nurse will participate in identifying processes, systems, and practice metrics, and determining care outcome measures. Screening potential case management clients for appropriateness and benefit is also a key duty. The position encourages the introduction of innovative nursing techniques and approaches to provide efficient, comprehensive, and cost-effective services. The nurse will coordinate with multidisciplinary teams, participate in the Case Management Program (CMP), and ensure it meets established standards. Expertise in the CM process, including assessment, planning, implementation, coordination, and monitoring, is required. The role involves developing and implementing local strategies using various CM approaches and tools, integrating CM with utilization management (UM), and maintaining liaison with community agencies. Accurate data collection and documentation in the electronic healthcare record are essential. Treatment plans will include preventive, therapeutic, rehabilitative, psychosocial, and clinical interventions. The contract nurse will perform duties similar to military or Government civil service nurses of similar experience. Identifying and recommending alternatives for problems with healthcare access and utilization in both military and civilian sectors is also part of the role. Updates to patient charts are required within 72 business hours post-appointment, with high visibility or higher acuity patients requiring updates by Close of Business (COB). The role also involves following SOPs for duty limitations, weapons access assessments, and safety notifications, focusing on low to moderate safety risk patients.

Requirements

Baccalaureate Degree of Nursing from a college or university accredited by Accreditation Commission for Education in Nursing (ACEN), the Commission on Collegiate Nursing Education (CCNE) or as otherwise outlined in this PWS.
Possess one of the following certifications: Commission for Case Manager Certification Certified Case Manager (CCM), Certification of Disability Management Specialists Commission: Certified Disability Management Specialist (CDMS), Association of Rehabilitation Nurses: Certified Rehabilitation Registered Nurse (CRRN), American Board for Occupational Health Nurses Certified Occupational Health Nurse (COHN) or Certified Occupational Health Nurse-Specialist (COHN-S), National Board for Certification in Continuity of Care: Advanced Certification in Continuity of Care (ACCC), Commission on Rehabilitation Counselor Certification: Certified Rehabilitation Counselor (CRC), American Nurses Credentialing Center Nurse Case Manager (RN-NCM), National Academy of Certified Care Managers: Care Manager Certified (CMC).
One year of experience in nursing as identified in this PWS after graduation.
Current, full, active, and unrestricted license to practice as a Registered Nurse as required in this PWS.

Nice To Haves

Basic Life Support certification

Responsibilities

Provide clinical nursing, administrative and organizational skills in managing the continuity of care for the beneficiary populations supported through the Virtual Medical Center (VMC).
Conduct comprehensive assessments of Active-Duty Service Members health needs to develop a plan of care.
Plan with the patient, the family, the physician/provider, other healthcare providers, the payer, and the community to maximize healthcare response and quality cost effective outcomes.
Facilitate communication and coordination between members of the healthcare team.
Educate both the patient and members of the healthcare delivery team about case management, healthcare and treatment options, community resources, insurance benefits, psychosocial concerns, etc., so that informed decisions can be made.
Engage in problem solving, exploring options to care when available and alternative plans when necessary to achieve desired outcomes.
Encourage appropriate use of healthcare services and strive to improve quality of care and maintain cost effectiveness.
Empower patients and serve as an advocate for both patients and the healthcare team to facilitate positive outcomes.
Coordinate follow-up consult and care services for Service Members supported by the VMC.
Participate in the identification of processes, systems, and practice metrics; and in determining measures of care outcomes for the population served.
Screen all potential case management clients within established timeframe after identification for appropriateness/benefit of case management services to client and/or Institution.
Introduce innovative nursing techniques, practices, and approaches in collaboration with health care providers to identify, assess, educate, plan, and coordinate care through programs designed to provide efficient, comprehensive, and cost-effective service for case managed patients.
Coordinate with patient-focused multidisciplinary teams of clinicians to develop treatment timelines.
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, MTFs and organizations.
Accurately collect and document patient care data in electronic healthcare record.
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.
Contract nurses providing services under this contract shall perform the same clinical duties as those required of any military or Government civil service nurse of similar experience assigned to the same unit.
Identify problems with health care access and utilization in both the military and civilian sectors and recommends alternatives to overcome these difficulties.
Updates patients� charts/information within 72 business hours post appointment.
Documentation for a high visibility or higher acuity patient shall be updated within COB to allow shared visibility to shared providers.
HCW shall follow the SOP�s duty limitations, weapons access assessments.
Safety and notification are a multi-disciplinary approach using providers, provider extenders, and case management teams.
This solution will focus on low to moderate safety risk patients allowing the Military Treatment Facility (MTF) to focus on the higher needs, specialty needs of Soldiers in person.