Registered Nurse - Case Manager

• 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 assessment, clinical practice guidelines, algorithms, CM software, and databases for community resources.
• Integrate CM and utilization management (UM), and integrate nursing case management with social work case management.
• Maintain liaison with appropriate community agencies and organizations.
• Accurately collect and document patient care data.
• Develop treatment plans including preventive, therapeutic, rehabilitative, psychosocial, and clinical interventions to ensure continuity of care towards the goal of optimal wellness.
• Establish mechanisms to ensure proper implementation of patient treatment plan and follow-up post discharge in ambulatory and community healthcare settings. Provide appropriate healthcare instruction to patients and/or caregivers based on identified learning needs.

• Utilize available automated programs and information technology, communication, and management tools for proactive patient management and to facilitate patient engagement and enhance patient experience (i.e., MHS Genesis, TSWF, CarePoint and Patient Portal Secure Messaging).
• Communicate with patients utilizing asynchronous Secure Messaging (i.e., MHS Genesis Patient Portal) to improve communication and facilitate care through non-traditional means.
• Assist in coordinating a multidisciplinary team to meet the healthcare needs, including medical and/or psychosocial management, of specified patients. 5.1.6.2. Serve as a consultant to all disciplines regarding CM issues.
• Develop and implement policies and protocols for home health assessments and outcome measures.
• Prepare routine reports and conduct analyses. • Assist in establishing and maintaining liaison with appropriate community agencies and organizations, the TRICARE Lead Agent office, and the Managed Care Support Contractor.
• Maintain adherence to JCAHO, URAC, CMSA, and other regulatory requirements. Apply medical care criteria (e.g., InterQual).
• Ensure accurate collection and input of patient care data and ensure basic CM budgetary management.
• Provide input on MTF CM resources and make recommendations to the Command as to how those resources can best be utilized.
• Collaborate with the multidisciplinary team members to set patient-specific goals.
• Establish and implement mechanisms to ensure proper implementation of patient treatment plan and follow-up post-discharge in ambulatory and community healthcare settings.
• Provide nursing advice and consultation in person and via telephone.
• Ensure appropriate healthcare instruction to patients and/or caregivers based on identified learning needs.
• Alert physicians to significant changes or abnormalities in patients and provide information concerning their relevant condition, medical history, and specialized treatment plan or protocol.
• Facilitate multidisciplinary discharge planning and other professional staff meetings as indicated for complex patient cases and develop a database and knowledge of local community resources.
• Develop and implement mechanisms to evaluate the patient, family, and provider satisfaction and use of resources and services in a quality-conscious, cost-effective manner.
• Implement strategies to ensure smooth transition and continued healthcare treatment for patients when the military member transfers 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.
• Plan for professional growth.

• Degree: Possess a Bachelor's degree in Nursing from an accredited university. You can also possess a Master's Degree in Nurse Case Management from a program accredited by the American Nurses Credentialing Center (ANCC) with one of the certifications mentioned below.
• Education: Graduate from a college or university accredited by the National League for Nursing Accrediting Commission (NLNAC) or The Commission on Collegiate Nursing Education (CCNE).
• Experience: Possess a minimum of 5 years of experience as an RNCM within the past 7 years.
• Certification: Possess and maintain a current certification from one of the accredited organizations mentioned below: (CCM), (CDMS), (CRRN), (COHN), (ACCC), (CRC), (RN-NCM), (CMC). Alternatively, you can possess a Master's Degree in Nurse Case Management from a program accredited by the American Nurses Credentialing Center (ANCC).
• Licensure: You must have a current, full, active and unrestricted license as a Registered Nurse.
• Security: You must possess the ability to pass a Government background check/security clearance.
• Life Support Certification: You must possess a current AHA or ARC BLS Healthcare Provider certification.

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