SUMMARY:

Performs healthcare coordination and case management activities IAW Medical Treatment Facility (MTF) instructions.

ESSENTIAL DUTIES & RESPONSIBILITIES:

• 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.
• Other duties as assigned.

MINIMUM QUALIFICATIONS:

• 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 Registered Nurses (RN) licensed in Colorado, be able to practice using a nurse compact state license, or have a license from any United States jurisdiction.
• Must maintain a current, valid and unrestricted State nursing/social worker license in good standing.
• Case Management certification desired.
• Extensive knowledge of TRICARE, Medicare/Medicaid services and benefits is mandatory. Strongly preferred working knowledge of the military health care system as well as local community resources.
• Demonstrates ability to prioritize, organize, problem-solve and coordinate daily activities to support effective improvement in individual patients.
• 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.).
• RNs must have current Basic Cardiac Life Support (BCLS) certification from the American Red Cross. This certification shall be maintained in a current status at all times while performing services under this contract at no expense to the Government.
• 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.

DESIRED QUALIFICATIONS & SKILLS:

• 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 he/she 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.

WORK SCHEDULE:

• Monday - Friday
• 0730 - 1630
• Hours may vary by MTF and are subject to change based on the patient care needs

TRAVEL:

All Market contractors are subject to working at a duty location at any of the MTFs or associated sub clinics within the Colorado Military Health System (CMHS).

DRIVING REQUIREMENTS:

None

PHYSICAL DEMANDS:

Position consists of sitting for long periods of time, using hands/fingers, handling, reaching with hands and arms, speaking, or translating. Periods of walking, standing, bending, kneeling, stooping, crouching, and lifting boxes weighing up to 30 pounds. Moderate to extended periods of office work with heavy periods of computer usage. May be assigned occasional to moderate periods of analytical tasks requiring extensive reasoning abilities. It is Katmai’s business philosophy and practice to provide reasonable accommodations, according to applicable state and federal laws, to all qualified individuals with physical or mental disabilities.

WORK ENVIRONMENT:

Work is performed primarily indoors at a well-lit military treatment facility such as a clinic, outpatient facility or hospital. The environment is normally air conditioned, but conditions may change dependent upon circumstances. Work may need to be performed in a fast-paced environment requiring quick thinking and rapid judgements. Employee will be exposed to a wide variety of clients in differing functions, personalities and abilities. Exposure to bloodborne pathogens and bodily fluids, latex, radiation or other contaminants and safety issues. May be exposed to infection or diseases from contact with patients. Work is highly social with patients and can be stressful with a high emotional element. Decisions made may substantially impact patients and their families.

COMPENSATION & BENEFITS PACKAGE

• Pay is: $33.22 to $37.63 per hour.
• Eligible Benefits: Medical, Dental, Vision, Group Term Life & AD&D Insurance, Voluntary Life and AD&D Insurances, Voluntary Long-Term & Short-Term Disability Insurance, Dependent Spouse Life Insurance and Dependent Life Insurance, Prescription Drug Coverage, Hearing Coverage, 401(k) Savings Plan, Employee Assistance Program (EAP), Vacation & Paid Personal Time, 11 Paid Federal Holidays, and Leave of Absence

Compliance:

To be considered for this position, all applicants must apply on the company website, https://katmaicorp.com/life-at-katmai/

We are a VEVRAA Federal Contractor

We are an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to age, race, color, religion, sex, sexual orientation, gender identity or national origin, disability status, protected veteran status, or any other characteristic protected by law. https://katmaicorp.com/life-at-katmai/#equal_opportunity Preference will be given to Ouzinkie Shareholders, Descendants of Shareholders, and Spouses of Shareholders in accordance with Title 43 U.S. Code 1626(g) and Title 42 U.S. Code 2000e - 2(i). Executive Order 11246, as amended, protects applicants and employees from discrimination based on inquiring about, disclosing, or discussing their compensation or the compensation of other applicants or employees.