Location: Winslow, AZ Exit Disclaimer: You Are Leaving www.ihs.gov
Type: TribalSalary Range: $55,129 to $88,206 / Per Year Open Period: 2/3/2015 to 3/13/2015 Summary: Under general supervision of the Contract Health Supervisor, the RN Case Manager provides utilization review and case management for patients referred for in-patient care to other healthcare facilities. The RN Case Manager will develop, implement, and evaluate individualized patient care plans and act as a liaison between patients, their families, and healthcare providers. Maintains confidentiality of all privileged information. Duties: • Maintains regular attendance and punctuality.• Provides ongoing support and expertise through comprehensive assessment, care planning, plan implementation and overall evaluation of individual patient needs from notification of admission to post discharge.• Collaborates with the patient/family and an interdisciplinary team to ensure continuity and quality of care, and control health care costs.• Conducts appropriate concurrent and retrospective reviews on referred care patients to determine the appropriateness of admission, procedures, and the necessity of continued hospital care. • Collaborates with other facilities to determine medical necessity and appropriateness of level of care using Centers for Medicare & Medicaid Services (CMS) approved criteria for inpatient and outpatient referred care encounters. Checks the severity of illness, intensity of service and discharge criteria on referred patients. • Refers appropriate cases to the Chief Medical Officer for medical review.• Refers patients without insurance to patient benefits coordinators to screen for alternate resources.• Works closely with Patient Business Coordinator and Contract Health Services (CHS) to maximize the use of alternate resources for referred care payment, protecting CHS funds for those patients who do not qualify for alternate resources. • Certifies (informally) the acute hospital level length of stay for CHS payment and Winslow Indian Healthcare Center utilization purposes. • Determines if services are being delivered as planned, if services are meeting needs, reassesses at appropriate intervals to determine if the patient’s condition or situation has changed, and revises goals and plan of services accordingly. • Works collaboratively with other departments to coordinate patient needs before discharge, discharge planning activities and continuity of care. • Serves as an advocate for the patient and their families.• Maintains department productivity and quality measures.• Manages and completes assigned work plan objectives and projects in a timely manner.• Provides education to WIHCC staff as needed regarding chronic and acute diseases as they relate to case management issues, length of stay, discharge planning, etc.• Chairs the Manage Care Meetings on a weekly basis.• Maintains confidentiality in accordance with HIPAA/HITECH, departmental policy, and professional standards.• Uphold all principles of confidentiality and patient care to the fullest extent. • Adhere to all professional and ethical behavior standards of the healthcare industry. • Interact in an honest, trustworthy and dependable manner with patients, employees and vendors. • Possess cultural awareness and sensitivity. • Performs other duties as assigned. Qualifications: Bachelor of Science in Nursing required. Valid Registered Nursing license from one of the 50 states required. Ten years of Registered Nurse experience required. Current BLS/CPR is required. ACLS/PALS, TNCC, ENPC and ATCN are strongly recommended. Certification in Case Management preferred. Bilingual skills in English and Navajo language preferred. Must maintain a valid unrestricted and insurable driver’s license. Must successfully pass a background investigation and maintain suitable requirements for a Child Care position. This position is considered as a Child Care position, which requires a satisfactory background check investigation and is subject to the requirements of the Indian Child Protection and Family Violence Prevention Act, as amended (henceforth referred as the ICPFVP Act). Work Type: Permanent, Full Announcement #: 15-004 Who May Apply? All Groups of Qualified Individuals Get Details & Apply: http://www.wihcc.com Exit Disclaimer: You Are Leaving www.ihs.gov