Registered Nurse Case Manager Job at Quacito LLC, San Antonio, TX

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  • Quacito LLC
  • San Antonio, TX

Job Description

Registered Nurse Case Manager

GENERAL DESCRIPTION

The Nurse Case Manager shall provide services in support of Individual Medical Readiness to the US Army Reserve Regional Support Commands (RSC) and Medical Management Activity (MMA) as well as a wide range of Case Management support services to Soldiers found to have medical issues or
concerns that are medically not ready for mobilization/training and require referral management for care/treatment or for appropriate medical board. The quality of care provided by the contractor shall be of a quality meeting or exceeding currently recognized national standards as established by the Joint Commission (JC), American Hospital Association (AHA), American Medical Association (AMA), Department of Defense, and Army Medical Department, and established principles and ethics of the medical profession. The Registered Nurse Case Managers shall provide services in conjunction with other non-contract providers to include medical officers, nurse case managers, and para-professional clinical personnel. Registered Nurse Case Managers shall give the highest regard to patient dignity and observe the precepts of the American Hospital Association’s Bill of Rights for Patients. The Registered Nurse Case Manager shall abide by facility location’s rules, regulations and by laws, including Medical Staff By laws, as well as applicable Army regulations governing such things as medical records. This contract is a personal services contract and is intended to create an employer-employee relationship between the Government and the individual contract health care providers only to the extent necessary for providing the healthcare services required under this contract.

QUALIFICATION REQUIREMENTS

Education and Experience:
Registered Nurse (RN) Case Managers shall have graduated from a nursing program accredited by
the American Association of Colleges of Nursing or the National League for Nursing.
Minimum of 1 year of case management experience in either inpatient or outpatient setting, and be
able to function with minimum guidance and supervision.

Licensure and Certification:
All Registered Nurse Case Managers will have taken and passed the National Council of State
Boards of Nursing’s (NCSBN) National Council Licensure Examination-Registered Nurses
(NCLEX-RN).
Valid, current, unrestricted, Registered Nurse (RN) license from a U.S. jurisdiction to provide
healthcare within the appropriate scope of practice. The Registered Nurse Case Manager must maintain their license(s) for the duration of the contract.
All contract HCPs shall be required to meet the Continuing Medical Education (CME) requirements
as required by their license.
Current Basic Life Support (BLS) certification from the American Heart Association.
Current credentials must be maintained at the assigned worksite and may require periodic updates. Knowledge, Skills, and Abilities:
Computer skills to enable them to develop working knowledge of e-MEB, e-Profile, e-case, MNR
tracker, MND, HRR, and MODS/MEDPROS/MEDCHART, LOD, AHLTA, VISTA.
Ability to enter data and prepare reports in MS Office programs including Microsoft Word, Excel, Power Point and Access. Ability to communicate effectively orally and in writing.
Additional requirements include:
U.S. Citizenship (certified copy of birth certificate or naturalization papers).
Possess communication skills, problem solving skills, solid background in general nursing.
Strong organizational skills and ability to work independently are also required.
Ability to work collaboratively with the Case Management Team and designated military personnel.
Must meet all contract mandated occupational health requirements including immunizations and the
PPD (TB) test as directed by the MTF.

REQUIRED TRAINING

Continuing education is required to maintain licensure. Time off to attend training selected by the
individual cannot not be billed to the government.
Initial and recurring training required by local MTF commanders or their supervisors. These
training and include program specific as well as site specific training such as CHCS training, safety
training, utilization of the PDH-CPG, etc.
In addition to the requirements to attend training defined above, the government may make available
to Contract Clinical Social Workers; government sponsored training opportunities such as
conferences and professional development courses that may enhance their ability to provide services
to eligible beneficiaries with the approval of the Contractor, the Contracting Officer, Program Manager and the Clinical Social Worker’s supervisor. Attendance may be at government expense if funds are available.

WORK SCHEDULE & LOCATION(S)

Required services may be scheduled between the hours of 6:00 a.m. to 7:00 p.m., Monday through
Friday, excluding U.S. Federal Holidays. A typical workday will generally consist of 8 hours plus a
1 hour unpaid lunch break. A provider can be scheduled to work a minimum of 8 hours and a maximum of 12 hours per day. Work hours are typically 0800 – 1700.
No overtime is paid. Nurse Case Managers will receive time off per worksite policy for hours
worked in excess of 40 hours per week.

Nurse Case Manager worksite:
Army Reserve Medical Command
2801 Grand Ave.
Pinellas Park, FL 33782

ESSENTIAL JOB FUNCTIONS

Nurse Case Managers provide guidance and assistance to Soldiers who require referrals for medical treatment or care, and assist Soldiers with Individual Medical Readiness (IMR) support to include identification and tracking of Soldiers who are not Medically Ready (MR). RN Case Managers collect and review performance data and work with the Army Reserve (AR) Surgeon’s office to tailor processes to meet specific USAR wounded, ill and injured Warriors, and coordinate with USAR Recovery Care Coordinators (RCCs) for non-medical case management and Family needs, in order to deliver the highest possible quality of care support.
The Nurse Case Managers will work in collaboration with the RSC Surgeons or MMA Surgeon to facilitate identification of the MNR population, ensure assessment of the MNR population and will coordinate with unit leaders and available medical options to determine what the MNR Soldiers need. Assist Soldiers in managing referrals for care and in becoming medically ready (MR) or begin medical boarding packet building. Provide guidance and assistance to Soldiers who require referrals for medical treatment or care and assist soldiers with individual medical readiness (IMR) support to include identification and tracking of soldiers who are not medically ready (MR).
Nurse Case Managers will have access to MODS/MEDCHART, PHA, LOD, E-MEB, AHLTA,
VISTA, MEDPROS, AKO, AVS, e-Profiles, Mebitt, Health Readiness Record (HRR), MNR tracker
and e-case and 25 day module.
Case Managers shall be familiar with and understand regulations pertinent to managing Soldiers who
have medical issues and medical readiness without deviation from standard.
Collaborate with RSC Surgeon, MMA, CMMD Surgeon or designee when assistance is required.
Communicate and create record for every MNR Soldier within 30 days of receipt of notification that
Soldier is MNR.
Coordinate with Soldier to assess and develop plan of care or treatment of conditions that have or
will result in Soldier’s medically not ready status. Educate MNR Soldiers with scheduling of appointments for evaluation or treatment through Military Medical Support Office (MMSO) if duty related, through civilian providers if not duty related, or if VA eligible.
Ensure documentation is received and filed appropriately.
Manage MNR Soldier’s plan of care from receipt of case referral or notification through case
closure, as required.
Perform intake interview with Soldier and establish communication with command.
Ensure Soldiers understand his/her responsibilities for making and keeping appointments and
provide the Nurse Case Manager with medical documentation.
The Nurse Case Manager is responsible for educating the Soldier about their privacy rights and how
their information may be used and obtains consent for release of medical information.
Coordinate care through TRICARE and MMSO for Soldiers who have duty related injuries or illnesses.
Secure documents and assist in entry of documents required to complete a LOD packet for submission.
Assists MNR Soldier in arranging health care with Military Treatment Facilities, Veteran’s Administration (VA), TRICARE network providers and non-network providers
The Nurse Case Manager will provide a biweekly case report to the RSC, MMA Surgeon or designated representative. The report should include number of cases opened, closed, referrals made, important unresolved issues and the number of cases identified needing a MEB. The Nurse Case Manager will also provide entry into the tracking system (currently MNR tracker).
Educate Soldiers on resources available to improve medical and dental readiness.
The Nurse Case Manager will develop and implement a plan of care and improvement with collaboration with the RSC Surgeon, MMA Surgeon or designated representative.
Establish and maintain a usable schedule, track and report work hours and expenses weekly, evaluate
all deliverables to ensure high quality, ensure projects meet internal and external expectations,
customize reports required by client, use expert judgment in all areas of this project, be prepared to
discuss project quality, team satisfaction and success and metrics weekly.
Continually seek improvement to increase client satisfaction, manage day to day operations, and
develop lasting relationships with client personnel.
The Case Reviewer will work collaboratively with the Nationally Certified Case Manager, Case
Managers, and designated military personnel. The Case reviewer will assist in the review process of
temporary or permanent P3/4 profiles, contact Soldiers to obtain medical documentation,
communicate with Commands and unit as required.
Performance Metrics and Management Plan (PMMP). Upon receipt of a temporary or P3/4 profile from the Surgeon or designee, the Case Manager will open a case and communicate with the Soldier within 30 days, to include entering case in Medically Non Ready (MNR) tracker. After 30 additional days, if documentation has not been received by the Case Manager a notification letter will be sent notifying the command and the Soldier. If documentation is received the, Nurse Case Manager will review it within 7 days of receipt and according to medical condition and
circumstances guide the Soldier through the validation process. If a focused examination for a duty related condition is required, the Nurse Case Manager will ensure that a referral for an appointment
is made within 7 days, and documentation from that appointment is received and reviewed within 14 days from the appointment. If the focused exam reveals the Soldier requires a medical board the
Nurse Case Manager and administrative staff will begin the process of compiling the medical information (profile, PHA, pertinent medical documentation related to the condition that does not meet retention standards) Medical Evaluation Board (MEB) packet and submit to the Surgeon for review. Incomplete Line of Duty investigations will be initiated within 7 days of receipt of
information.
Priority of cases will be determined by the Surgeon cell. All actions will be documented in an OCAR Surgeon approved electronic medical system.
Performs other duties as assigned.
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Job Tags

Holiday work, Permanent employment, Contract work, Temporary work, For contractors, Local area,

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