RN Case Manager - United States Air Force Academy

• Ensures compliance with standards of care and practice (Accreditation Association for Joint Commission on Accreditation of Healthcare Organizations (JCAHO), Ambulatory Health Care (AAAHC) & Case Management Society of America (CMSA)).
• Collaborates with military and civilian healthcare providers and staff and uses Utilization Management (UM) systems support to identify high-risk/high-cost patients within MTF population.
• Determines eligibility for healthcare coordination/case management services.
• Coordinates with healthcare providers to ensure appropriate appointment alternatives, access and quality of care.
• Coordinates services for eligible patients based on subjective and objective assessment data and identified patient/family needs.
• Facilitates a multidisciplinary team to develop a treatment plan to address all identified conditions and problems. Integrates health education, promotion and prevention activities utilizing available MTF and local civilian condition/disease management resources. Participates in the orientation, training, and evaluation of competency of newly assigned Case Management personnel.
• Attends bi-weekly and as-needed multi-disciplinary discharge planning conferences within the MTF and as needed at the local treatment facilities.
• Assists TRICARE eligible and Medicare-eligible patients in accessing local TRICARE and Medicare providers in conjunction with the MTF Referral Centers and the Central Referral Center.
• Maintains current directories of local Medicare providers, suppliers, and Institutions.
• Evaluates case management process utilizing defined parameters such as admissions, length of stay, level of care, Emergency Department/outpatient clinic visits and patient outcomes and institutes appropriate interventions.
• Generates and maintains appropriate patient administrative records and provides upon request.
• Reports monthly summary of care to Director, Medical Management (MM) or designee.
• Conducts monthly evaluation, in conjunction with Primary Care Management (PCM) team, the benefit of case management. Closes case management cases when maximum patient benefit has been obtained.
• Ensures a safe work environment and employee safe work habits.
• Maintains regular and punctual attendance.
• Performs all other duties as assigned.

• Bachelor of Science Degree in Nursing (BSN) from a National League of Nursing (NLN) or American Academy College of Nursing (AACN) accredited college or university as delineated by Headquarters United States Air Force Surgeon General.
• Minimum of three (3) years of documented medical or surgical experience and at least one (1) year experience in Case Management.
• Possess a current, active, full, and unrestricted license in any US United States or jurisdiction, be able to practice using a nurse compact state license or Enhanced Nurse Licensure Compact (eNLC) or have a license from any United States jurisdiction.
• Must maintain a current, valid, and unrestricted State nursing/social worker license in good standing.
• Extensive knowledge of TRICARE, Medicare/Medicaid services and benefits is mandatory.
• Knowledge of professional care theories, principles, practices, and procedures to perform patient assessments with specific experience in the case management evaluation and assessment of pediatric, adult, and geriatric patients as appropriate.
• Demonstrates knowledge, skill, and ability to use basic office automation and information management equipment and programs (i.e., word processing, database management, email, etc.).
• Life Support Certifications: Must possess and maintain current Healthcare Provider Basic Life Support (BLS). This Certification must be current at all times, at no additional expense to the government.
• Must obtain and maintain all required documents, certifications, licenses, etc. listed on the credentialling checklist, sent by Katmai's Credentialing Specialist, for this position for initial hire. All certifications listed must be maintained. Expired certifications are not valid.
• Must obtain and maintain the site's required health screening and immunization requirements.
• Must obtain and maintain any necessary security access and/or background checks.
• Must obtain and maintain all required documents, certifications, licenses, etc. listed on the credentialling checklist, sent by Katmai's Credentialing Specialist, for this position for initial hire.

• Case Management certification desired.
• Working knowledge of the military health care system as well as local community resources strongly preferred.
• Experience in outpatient, home-health care, skilled nursing facility, hospice and mental health services are desired.
• Experience with Medicare Eligible patients preferred.
• Excellent patient assessment skills.
• Excellent oral communication skills for patient education and telephone management of patients.
• Sufficient initiative, interpersonal relationship skills and social sensitivity such that they can relate constructively to a variety of patients and healthcare staff from diverse backgrounds.
• Ability to effectively read, write and speak English in order to communicate with all patients and other healthcare providers.
• Ability to effectively communicate and collaborate with a diverse group of people for the purpose of informing the healthcare team of plans/actions, for teaching/education to benefit the patient/family and organization.
• Excellent written communication skills to perform accurate documentation, both written and electronic, of all activity in accordance with requirements.
• Demonstrates ability to prioritize, organize, problem-solve, and coordinate daily activities to support effective improvement in individual patients.

• Pay range: $35.02 per hour.
• H&W: $4.93
• Eligible Benefits: Medical, Dental, Vision, Life & AD&D Insurance, Long-Term & Short-Term Disability Insurance, 401(k) Savings Plan, Employee Assistance Program (EAP), Vacation & Paid Personal Time, 11 Paid Federal Holidays, and Leave of Absence.

Katmai