Specific duties include, but are not limited to:

• Assess and proactively identify/evaluate patients for discharge planning/case management within 24 hours of identification or notification, or by close of the first business day after a weekend or holiday. Conduct systematic, on-going, thorough collection of patient’s physical, emotional, psychological, social and medical status and information via direct patient contact, family/caregiver, and other relevant sources such as professional and non-professional caregivers. Review the patient’s medical record against McKesson (InterQual) discharge planning criteria to determine readiness for discharge.
• Plan and develop appropriate patient-specific discharge plan of care within 5 working days of discharge. Shall coordinate, collaborate, and obtain approval of the plan among the patient, family/caregiver, primary provider and other members of the healthcare team. Document review of the plan in the patient’s medical record. Shall develop a proactive process for patients undergoing same day surgeries, anticipating actual and potential needs for post-operative services.
• Implement, coordinate and execute the discharge plan with the patient and family/caregiver, optimizing access to appropriate services. Shall ensure necessary referrals are ordered by the appropriate discipline and coordinated. Serves as an advocate for, and ensures education is provided to, the patient and family/caregiver as required. Shall promote adherence to the discharge plan for improved healthcare outcomes.
• Ensure coordination of care delivery processes, to include alternate healthcare settings and the home environment, for the purposes of enhancing the patient's health and wellness, safety, productivity, and quality of life, and for providing the most beneficial, cost-effective health care. Shall develop, utilize and maintain a variety of military and community resources to optimize access to services and medical care. Shall ensure timely and appropriate provision of services.
• Re-evaluate the patient and the plan every 72 hours until discharged per McKesson (InterQual) guidelines, aligning the plan with TRICARE benefits and policies documents in accordance with existing local facility/AF/DoD and other agency guidelines. Shall maintain data collection in accordance with local facility/AF/DoD and other specified agency guidelines. Such data includes but is not limited to resource utilization and patient outcomes, and Length of Stay (LOS) and Avoidable Bed Days, analyzing for variance, appropriate interventions and cost containment.
• Conduct timeliness in completion of the discharge plan, patient’s adherence and response to the plan, identification of variances, patterns or trends from established practice guidelines and/or standards, established outcome measurements, results of interventions, treatment delivery and timeliness of care, and utilization of resources. Monitors and evaluates the facility’s discharge planning program per local facility/AF/DoD policies and guidelines.
• Maintain a level of productivity and quality consistent with complexity of the assignment; facility policies and guidelines; established principles, ethics and standards of practice of professional nursing; the Case Management Society of America (CMSA); American Accreditation Healthcare Commission/Utilization Review Accreditation Commission (URAC); CAMH; (AAAHC); Health Services Inspection (HSI); and other applicable DoD and Service specific guidance and policies. Shall also comply with the Equal Employment Opportunity (EEO) Program, infection control and safety policies and procedures and follow applicable local facility/AF/DoD instructions, policies and guidelines.
• Demonstrate knowledge and experience in Patient Advocacy, Patient Privacy, and Customer Relation. Respect and maintain the basic rights of patients, demonstrating concern for personal dignity and human relationships. Only release medical information obtained during the course of this contract to other MTF staff involved in the care and treatment of that individual patient.
• Serve and participate in committees, functions and other meetings as directed. Shall provide relevant and timely information to these groups and assists with decision-making and process improvement. Shall participate in customer service initiatives, quality projects, and medical readiness activities, designed to enhance health services.
• Participate in clinic quality assurance programs to meet standards for the Joint Commission, in QA/RM activities to the extent required by AFI 44-119, Chapters 3, 6 and 8 and the individual MTF QA/RM plan or regulation.
• Complete medical record documentation and coding, and designated tracking logs and data reporting as required by local facility/AF/DoD instructions, policies and guidance and complete all required electronic medical record training, facility-specific orientation and training programs, and any AF/DoD mandated training.
• Prepares all documentation to meet or exceed established MTF standards, to include, but not limited to: timeliness, accuracy, content, and signature, use MTF and Air Force-approved abbreviations for documentation in the patient health records and follow the MTF’s Do Not Use Abbreviation List, (AFI 44-172 / AFI 48-123, Medical Examinations and Standards, 5 November 2013) with no more than 2 deficiencies per month, complete medical records documentation within 72 hours of the encounter with the patient, use the proper coding of procedures and treatment at 90% or higher, as military and civil service health care providers engaged in comparable work.
• Not dispose of any records without prior written approval of the Functional Area Records Manager (FARM) evidenced by the FARM's signature on the SF 135. If requested by the government, the contractor shall provide the original record or a reproducible copy of any such record within five working days of receipt of the request. All records, files, documentation, working papers, and software provided by the government or generated in the performance of this contract become and remain government property. All such records, files, documentation, and working papers, which this contract requires the contractor to maintain, shall be maintained in accordance with AFI 33-322, Records Management Program; AFI 33-364, Records Disposition-Procedures and Responsibilities; AF Electronic Records Management (ERM) Solution, AFRIMS, Records Disposition Schedule located at https://www.my.af.mil/gcss-af61a/afrims/afrims/ and all other pertinent directives, as supplemented.
• Comply with standards of care and practice in accordance with all established policies, procedures, and guidelines used in the medical treatment facility. The Department Functional Requirements Evaluator Designee (FRED) shall monitor the contractor employee productivity, monthly performance reviews, customer and staff comments, government information systems and records, customer service information, and time sheets.
• Must be knowledgeable of clinical and administrative theories, principles, practices, and procedures underlying nursing practice; effectively apply core discharge planning and case management functions: a) Assessment: Assesses every inpatient and same day surgery patient for discharge planning needs; b) Referral: Considers all needs for referrals to include TRICARE authorizations, durable medical equipment, special needs equipment/services, ongoing specialty medical care, case management, institutional referrals such as transfers for rehabilitative or nursing home care; c) Formulation: Collaborates with the provider and other members of the healthcare team as needed to determine the best discharge plan for the patient; d) Implementation: Reviews the discharge plan with the patient and the patient’s family/caregiver prior to discharge and documents the review in the patient’s medical record; e) Monitoring: Documents and updates the discharge plan as needed in accordance with local facility/AF/DoD policies and guidelines. Conducts periodic evaluations of the quality and effectiveness of the discharge planning process; be able to sit, stand bend or walk as required to accomplish primary duties of typing, shorthand, filing etc. for a period of a 9-hour duty day. Read, understand, speak, and write English fluently with excellent communications and customer service skills.
• Comprehension of the medical privacy and confidentiality (Health Insurance Portability and Accountability Act [HIPAA]) and accreditation standards of Accreditation Association for Ambulatory Health Care (AAAHC) and The Joint Commission (TJC). Working knowledge of computer applications/software to include Microsoft Office programs, MS Outlook (e-mail), and internet familiarity is required. The ability to input, extract and format data from established databases is desired. Have experience with McKesson (InterQual) and/or Milliman Care Guidelines and a working knowledge of DRGs, ICD-9, CPT-4, HCPCS coding and concepts Length of Stay (LOS) and Avoidable Bed Days. Possess ability to use basic computer skills to enter patient data and extract patients’ information, from a variety of sources to include Composite Healthcare System CHCS, Armed Forces Health Longitudinal Technology Application (AHLTA), Essentris (CPOE) and integrated clinical database (ICDB) and be proficient and independent in data entry within 2 months of start date.
• Possess organization, problem-solving and communication skills to articulate medical requirements to patients, families/care givers, medical and non-medical staff in a professional and courteous way. As well as demonstrate ability to apply critical thinking skills and expertise in resolving complicated healthcare, social, interpersonal and financial patient situations. Skillful and tactful in communicating with people who may be physically or mentally ill, uncooperative, fearful, emotionally distraught, and occasionally dangerous.

Work Schedule:

Monday - Friday, 9 hours between 6:00am and 5:00pm, including a one hour lunch

No Weekends or Holidays!

Excellent Compensation & Exceptional Comprehensive Benefits:Paid Vacation, Paid Sick Time, Plus 11 Paid Federal Holidays

Medical/Dental/Vision, STD/LTD/Life, Health Savings Account available, and more!
Annual CME Stipend and License/Certification Reimbursement

Matching 401K

Minimum Qualifications:

Degree/Education: Minimum ASNExperience : A minimum of 3 years of clinical experience as a RN, including at least 2 years in case management and/or discharge planning
Licensure: Active/unrestricted RN license from any state
Life Support Certifications:  BLS
Must be a U.S citizen and possess ability to pass a background check/security clearance

We are an equal opportunity employer and a drug free workplace. All applicants selected for employment are required to submit to a background check and pre-employment drug test.