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Case Management Nurse

Company: Chenega Corporation
Location: Montgomery
Posted on: August 7, 2022

Job Description:

Case Management opening in Montgomery, Alabama. This and other rn jobs brought to you by

Maxwell Ambulatory Healthcare Center, Maxwell AFB, AL

The Case Management Nurse shall proactively identifies and evaluates patients and families for case management from a variety of sources such as discharge/disposition planning, referrals, the Medical Evaluation Board (MEB) process, the healthcare system, employers and facility staff. Conducts systematic, on-going, thorough collection of patient's physical, emotional, psychological, social and medical status and information via direct patient contact and other relevant sources such as professional and non-professional caregivers, medical records, and family/caregiver interviews.

  • Develop an appropriate patient-specific plan of care to include short and long term goals, objectives and actions.
  • Coordinate, collaborate, and obtain approval of the plan among the patient, family/caregiver, primary provider and other members of the healthcare team.
  • Guide the patient and family/care giver through the healthcare system, maximizing use of resources.
  • Coordinate and executes the plan of care, optimizing access to appropriate services
  • Ensure necessary referrals are ordered by the appropriate discipline and coordinated.
  • Serve as an advocate for, and ensures education is provided to, the patient and family/caregiver as required.
  • Promote adherence to treatment plans for improved healthcare outcomes.
  • Document and update the treatment plan as needed in accordance with existing DoD, AF, local facility and other agency guidelines.
  • Maintain documentation and data collection in accordance with DoD, AF, local facility and other specified agency guidelines.
  • Conduct and/or participates in program evaluation as directed.
  • Monitoring and evaluation of the patient's adherence and response to the treatment plan; timeliness of patient and family/caregiver contact and follow-up; 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 case management program per DoD, AF and local policies and guidelines.
  • Coordinate and participates in interdisciplinary team meetings, designated facility meetings, and Care Coordination meetings.
  • Share knowledge and experiences gained from own clinical nursing practice and education relevant to nursing and case management.
  • Participate in the orientation, education and training of other staff.
  • May serve on committees, work groups, and task forces at the facility.
  • 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.
  • Must also comply with the Equal Employment Opportunity (EEO) Program, infection control and safety policies and procedures.
  • Follow applicable local MTF/AF/DoD instructions, policies and guidelines.
  • Complete medical record documentation and coding, and designated tracking logs and data reporting as required by local MTF/AF/DoD instructions, policies and guidance.
  • Complete all required electronic medical record training, MTF-specific orientation and training programs, and AF/DoD Case Management training.
  • Other duties as assigned


    • Associate's or Baccalaureate degree from a nationally accredited program in nursing recognized by the Education in Nursing (ACEN), the Commission of Collegiate Nursing Education (CCNE)
    • Current American Heart Association or American Red Cross hand-on Basic Life Support (BLS)
    • American Heart Association or American Red Cross Advanced Cardiac Life Support (ACLS) certification highly desirable.
    • Current American Heart Association or American Red Cross certification in Pediatric Advanced Life Support (PALS).
    • Minimum of two (2) years within the past five (5) years. This experience shall have been in a primary care clinic or case management/utilization management setting
    • Maintain an active, valid, current and unrestricted license (with no limitations, stipulations or pending adverse actions to practice nursing as a registered nurse in any US State
    • Possess one of the following certifications:

      • Commission for Case Manager Certification Certified Case Manager (CCM)
      • Certification of Disability Management Specialists Commission: Certified Disability Management Specialist (CDMS)
      • Association of Rehabilitation Nurses: Certified Rehabilitation Registered Nurse (CRRN)
      • American Board for Occupational Health Nurses Certified Occupational Health Nurse (COHN) or Certified Occupational Health Nurse-Specialist (COHN-S).
      • National Board for Certification in Continuity of Care: Advanced Certification in Continuity of Care (ACCC)
      • Commission on Rehabilitation Counselor Certification: Certified Rehabilitation Counselor (CRC)
      • American Nurses Credentialing Center Nurse Case Manager (RN-NCM)
      • National Academy of Certified Care Managers: Care Manager Certified (CMC)

        Knowledge, Skills and Abilities

        • Knowledge and ability to effectively apply the following core case management functions:

          a) Assessment: Identification of patients for case management; comprehensive collection of patient information and medical status; and continued evaluation of an established plan of care;
          b) Planning: Collaboration with the patient, family/caregiver, primary provider and other members of the health care team for developing an effective plan of care;
          c) Facilitation: Care coordination and communication among all involved parties;
          d) Advocacy: Support for the patient and family/caregivers to ensure identified education and appropriate, timely care is received

          • Knowledge of a variety of pharmacological agents used in patient treatment, the desired effects, side effects, and complications of their use as well as the accurate administration of the pharmacologic agent, including dosage calculations as required.
          • Knowledge of the administrative requirements for proper documentation of patient's condition including disease progress, acknowledgement of teaching, and follow up care.
          • Knowledge of 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), and the Clinical Practice Guidelines (CPGs).
          • 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
          • Must demonstrate ability to communicate effectively both orally and in writing.
          • Must be skillful and tactful in communicating with people who may be physically or mentally ill, uncooperative, fearful, emotionally distraught, and occasionally dangerous
          • Must have knowledge and experience, or demonstrate comprehension during training, with software and databases currently employed at the MTF (e.g. Microsoft Office, Access, Excel and PowerPoint; Medical Health System's (MHS) Genesis
          • Must possess knowledge, skills and computer program literacy to collect and analyze data.
          • Must have knowledge and experience in Patient Advocacy, Patient Privacy, and Customer Relations.
          • Must demonstrate ability to apply critical thinking skills and expertise in resolving complicated healthcare, social, interpersonal and financial patient situations.
          • Must 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.
          • Familiarity with Department of Defense (DoD), Federal, State, non-profit healthcare systems and organizations, to include DoD Tri-Service Military Healthcare Systems, TRICARE purchased care system, Medicare, Medicaid and the Veterans Administration (VA) is desired
          • Ability to maintain his/her license/certification . Providers who are licensed, registered or certified by national medical or allied health associations shall continue to meet the minimum standards for continuing education credits to maintain their license/certification.
          • Working knowledge of the military health care system including TRICARE health benefits or a working knowledge of the principles of fee-for-services, preferred provider network and managed care/HMO organizations is highly desirable

            Physical Demands (The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.)

            • While performing the duties of this Job, the employee is regularly required to sit and talk or hear. The employee may use repeated motions that include the arms, wrists, hands and/or fingers. The employee is occasionally required to walk, stand, climb, balance, stoop, kneel, crouch, or crawl. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision.

              Executive Order 13495, The Non Displacement of Qualified Workers Under Service Contracts provide first right of refusal to incumbents on contracts. If the position is accepted by the incumbent on the job, other application/resume of non-incumbents will not be reviewed.

              Keyphrases: medical case management jobs, case manager jobs, case manager consultant jobs, case management consultant jobs, geriatric case management jobs, case management nursing jobs, nurse case manager jobs

Keywords: Chenega Corporation, Montgomery , Case Management Nurse, Executive , Montgomery, Alabama

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