RN Case Manager - NHC Hawaii

Maxmed Healthcare•Jbphh, HI

10d•Onsite

About The Position

RN Case Managers are responsible for providing comprehensive case management services to eligible beneficiaries. This role involves assessing patient situations, developing and implementing care plans, coordinating with healthcare teams, and ensuring continuity of care across various settings. The position requires adherence to regulatory standards, utilization of medical care criteria, and collaboration with patients, families, and community resources to achieve optimal patient outcomes. Responsibilities also include facilitating discharge planning, managing patient transitions, and contributing to the improvement of the case management program.

Requirements

Possess a Baccalaureate Degree in Nursing, a Graduate Diploma in Nursing, or an associate degree in nursing, from an accredited agency such as the Accreditation Commission for Education in Nursing (ACEN) or the Commission on Collegiate Nursing Education (CCNE).
Basic Life Support Certification.
Possess a minimum of 1 year outpatient experience as an ambulatory care nurse within the last 2 years.
Experience providing services in psychiatric nursing, behavioral health and/or wellness counseling.
Possess and maintain a current unrestricted license to practice as a registered nurse in any of the 50 States, the District of Columbia, the Commonwealth of Puerto Rico, Guam, or the U.S. Virgin Islands.

Nice To Haves

Experience providing services in psychiatric nursing, behavioral health and/or wellness counseling.

Responsibilities

Conduct site visits to assess family situations and develop care plans.
Participate in multidisciplinary discharge planning and professional staff meetings.
Develop a database and knowledge of local community resources.
Establish TRICARE Online (TOL) accounts and be trained to use EWRAS or new systems.
Maintain adherence to Joint Commission, URAC, CMSA, and other regulatory requirements.
Apply medical care criteria (e.g., InterQual).
Make recommendations on MTF RN Case Manager resources and utilization.
Identify high-risk and/or high-utilizer populations.
Provide case management advice and consultation.
Collaborate with the healthcare team, patient, and family/support system to establish and update the case management plan of care.
Identify measurable short- and long-term goals/outcomes of care with matching strategies.
Incorporate the patient’s cultural background, values, beliefs, readiness to learn, and healthcare needs into the plan.
Provide the patient/family with the knowledge and skills necessary for plan implementation.
Facilitate patient and family decision-making activities.
Follow patients through hospitalization and follow up in ambulatory and community health care settings.
Measure the patient’s response to the plan of care and provide documentation.
Ensure appropriate health care instruction to patient and/or caregivers.
Develop and implement mechanisms to evaluate patient, family, and provider satisfaction.
Collaborate with the multidisciplinary team members to set patient-specific goals.
Develop treatment plans including preventive, therapeutic, rehabilitative, psychosocial, and clinical interventions.
Close cases when goals are met, patient declines service, patient transitions, or needs are no longer identified.
Provide case management orientation and education for new case managers.
Support other case managers, including managing caseloads during absences.
Facilitate and coordinate strategies for smooth transition and continued health care treatment for patients transferring out of the area.
Develop a policy for, and assist with, region-to-region 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.
Actively participate in professional organizations and attend at least one annual national CM conference.
Ensure all training completion documentation is submitted.
Participate in video teleconferences (VTCs) and other meetings.
Provide safe, quality clinical case management services in accordance with DoD, BUMED, Regional, directorate, and departmental instructions, policies, and procedures.
Keep informed of research and new information to ensure new methods and practices are incorporated.
Attend continuing education programs, seminars, and conferences.
Facilitate command cost containment through proper utilization of available resources.
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.