Registered Nurse Case Manager (RNCM)

Goldbelt Glacier is accelerating healthcare delivery and providing superior force health readiness across the military, federal, and civilian landscapes. Goldbelt Glacier is committed to providing transformative and comprehensive health operational capabilities to support customers across scientific, clinical, technological, and program management areas.

Summary:

As a part of the Goldbelt Glacier Team, you will be supporting the Naval Logistics Command with medical services for active-duty military personnel, their dependents, eligible DoD civilian employees, and other eligible beneficiaries designated by the Government. As a HealthCare Worker (HCW), you will be assigned to either a Military Treatment Facility (MTF) or other Federal medical treatment facilities in Japan.

Essential Job Functions:

• Participate in all phases of the Case Management Program (CMP) and ensure that the CMP meets established case management (CM) standards of care. Assist in coordinating a multidisciplinary team to meet the health care needs, including medical and/or psychosocial management, of specified patients.
  
• Serve as consultant to all disciplines regarding CM issues. Provide nursing expertise about the CM process, including assessment, planning, implementation, coordination, and monitoring. Identify opportunities for CM and identify and integrate local CM processes.
  
• Develop and implement local strategies using inpatient, outpatient, onsite and telephonic CM; develop and implement policies and protocols for home health assessments and outcome measures.
  
• Develop and implement tools to support case management, such as those used for patient identification and patient assessment, clinical practice guidelines, algorithms, CM software, databases for community resources, etc.
  
• Integrate CM and utilization management (UM) and integrate nursing case management with social work case management. Prepare routine reports and conduct analyses.
  
• Assist in establishing and maintaining liaison with appropriate community agencies and organizations, the TRICARE Management Activity, and the Managed Care Support Contractor.
  
• Maintain adherence to Joint Commission, URAC, Case Management Society of America (CMSA), and other regulatory requirements. Apply medical care criteria (e.g., InterQual).
  
• Assist with collecting and analyzing baseline data and ongoing outcomes to support continuous quality and cost-effective improvement. Identify gaps in existing services and assists in the development and implementation of appropriate services in a timely and cost-effective manner based on extensive knowledge of case management principles and established standards of care. 
  
• Provide input on MTF CM resources and make recommendations to the Command as to how those resources can best be utilized.
  
• Collaborate with the multidisciplinary team members to set patient-specific goals. Develop treatment plans including preventive, therapeutic, rehabilitative, psychosocial, and clinical interventions to ensure continuity of care toward the goal of optimal wellness.
  
• Work in conjunction with the entire healthcare team and other departments, to identify high-risk and/or high-utilizer populations to include but not limited to those beneficiaries with multiple providers, multiple admissions/readmissions, Emergency Department visits, catastrophic illness, chronic or terminal illness, and multiple medical problems/dual diagnoses.
  
• Identify and select clients who can most benefit from case management services available in a particular practice setting.
  
• Establish and implement mechanisms to ensure proper implementation of patient treatment plan and follow-up post discharge in ambulatory and community health care settings.
  
• Provide case management advice and consultation.
  
• Collaborate with other members of the healthcare team, the patient and/ family/support system on a regular basis to establish and update the case management plan of care using evidenced-based guidelines (when available and/or applicable).
  
• Identify measurable short-and long-term goals/outcomes of care with matching strategies to achieve optimal wellness and autonomy (self- management). Incorporate the patient’s cultural background, values and beliefs, readiness to learn and healthcare needs across the continuum of care into the plan.
  
• Provide the patient/ family with the knowledge and skills necessary for the implementation of the established plan. Facilitate patient and family decision-making activities by keeping them well informed of their rights, responsibilities, and options. When indicated, follow patients through hospitalization and follows up in ambulatory and community health care settings.
  
• Actively measure the patient’s response to the evidence-based plan of care and provide documentation that the plan and the quality of the services offered to the patient correspond to the identified needs.
  
• Ensure appropriate health care instruction to patient and/or caregivers based on identified learning needs.
  
• Facilitate multidisciplinary discharge planning and other professional staff meetings as indicated for complex patient cases and develop a database and knowledge of local community resources.
  
• Develop and implement mechanisms to evaluate the patient, family and provider satisfaction and use of resources and services in a quality-conscious, cost-effective manner.
  
• Collaborate with the multidisciplinary team members to set patient-specific goals. Develop treatment plans including preventive, therapeutic, rehabilitative, psychosocial, and clinical interventions to ensure continuity of care toward the goal of optimal wellness.
  
• Close cases when goals are met, patient declines service, patient transitions to another case manager or patient needs are no longer identified.
  
• Provide case management orientation and education for other case managers new to the role and/or facility providing scientific and practice-based knowledge per the Case Manager Core Competencies.
  
• Provide support to other case managers, including managing caseloads during absences.
  
• Facilitate and coordinate strategies to ensure smooth transition and continued health care treatment for patients when the military member transfers out of the area. Develop a policy for, and assist with, region-to-region transfers. This shall include coordination of required tests, procedures, treatments, discharge planning, community referrals, and transfers.
  
• Facilitate screening and assist with transfers of Exceptional Family Member Program (EFMP) families and service members going through the Integrated Disability and Evaluation System (IDES).
  
• Plan for professional growth and development as related to the case manager position and maintenance of CM certification. Actively participate in professional organizations including participation in at least one annual national CM conference to be funded by the government to be scheduled at the convenience of the government and the HCW. Ensure all training completion documentation is submitted to the region and HQ, as required.
  
• Participate in video teleconferences (VTCs) and other meetings as required.
  
• Provide safe, quality clinical case management services to a variety of eligible beneficiaries, in accordance with the Department of Defense (DoD), BUMED, Regional, directorate, and departmental instructions, policies and procedures.
  
• Keep informed of research and new information that will ensure new methods and practices are incorporated into the case management program; attends continuing education programs, seminars, and conferences to maintain core competencies in case management.
  
• Facilitate command cost containment through proper utilization of available resources and timely assessment of patient response to the case management program.
  
• Assist in the design, implementation, sustainment, and ongoing improvement of the case management program.
  
• Increase MTF staff involvement in and support of case management initiatives by providing orientation and ongoing education and in-service training specific to case management and the program.
  
• Participate in executing the Emergency Preparedness Plan (drills and actual emergencies) as scheduled by the MTF (typically semiannually).
  
• Participate in peer review and performance improvement activities.
  
• Participate in the implementation of the Family Advocacy Program as directed by government supervisor.
  
• Participation shall include, but not be limited to, appropriate medical examination, documentation, and reporting.
  
• Biological, Radiological, Nuclear and Explosives (CBRNE), and all other required training.
  
• Actively participate in the command’s Performance Improvement Program. Participate in meetings to review and evaluate the care provided to patients, identify opportunities to improve the care delivered, and recommend corrective action when problems exist.
  
• Perform efficiently in emergency patient situations following established protocols, remaining calm, informing appropriate persons, and documenting events. Anticipate potential problems/emergencies and make appropriate interventions.
  
• Notify supervisor, director, or other designated person regarding problems that the HCW is unable to manage.
  
• Comply with the standards of The Joint Commission, applicable provisions of law, and the rules and regulations of any and all governmental authorities pertaining to licensure and regulation of health care personnel and medical treatment facilities, the regulations and standards of medical practice and the MTF’s medical staff bylaws.
  
• Participate in continuing education to meet own professional growth.
  
• Participate in the provision of in-service training to clinic staff members.
  
• Provide training and/or direction as applicable to supporting government employees (e.g., hospital corpsmen, students, etc.).
  
• Operate and manipulate automated systems such as CHCS, AHLTA, ADS, Essentris, and Clinical Information System (CIS), participate in clinical staff Performance Improvement (PI) and Risk Management (RM) functions, as prescribed by the Commander.
  
• Attend and participate in various meetings as directed by government supervisor.
  
• The HealthCare Worker (HCW) shall comply with the HIPAA (Health Insurance Portability and Accountability Act) privacy and security policies of the treatment facility. Providers shall obtain/maintain a National Provider Identifier (NPI) in accordance with DOD and

Necessary Skills and Knowledge:

• Maintain a level of productivity comparable with that of other individuals performing similar services.
  
• Adhere to and comply with the Department of the Navy, Bureau of Medicine and Surgery, and local instructions and notices in effect during the term of the contract.
  
• Practice aseptic techniques as necessary; comply with infection control guidelines to include the proper handling, storage, and disposal of infectious wastes, and the use of universal precautions to prevent the spread of infection.
  
• Function with an awareness and application of safety procedures.
  
• Apply an awareness of legal issues in all aspects of patient care and strive to manage situations in a reduced risk manner.
  
• Exercise awareness and sensitivity to patient/significant others' rights, as identified within the MTF.
  
• Maintain an awareness of responsibility and accountability for own professional practice.
  
• Maintain DoD email account as directed by government supervisor.
  
• Exercise appropriate delegation of tasks and duties in the direction and coordination of health care team members, patient care, and clinic activities.
  
• Each HCW providing service under this contract or resultant task orders shall undergo an orientation and shall complete mandatory Navy and DoD on-line training as required.
  
• Be able to comply with all applicable Federal, State, and local laws, Department of Defense, Department of Navy, Bureau of Medicine and Surgery, and MTF instructions and policies.
  
• Proficiency in Microsoft Office software applications including Word, Excel, Access, PowerPoint, and Outlook.

Minimum Qualifications:

• Possess a Baccalaureate Degree in Nursing, a Graduate Diploma in Nursing, or an Associate Degree in Nursing, from an accredited agency such as the Accreditation Commission for Education in Nursing (ACEN) or the Commission on Collegiate Nursing Education (CCNE).
•  Possess and maintain a current unrestricted license to practice as a registered nurse in any one (1) of the 50 States, the District of Columbia, the Commonwealth of Puerto Rico, Guam or the U.S. Virgin Islands.
• Be a graduate of a school of nursing accredited by the Accreditation Commission for Education in Nursing (ACEN), formerly known as the National League for Nursing Accrediting Commission (NLNAC), or the Commission on Collegiate Nursing Education (CCNE) that conferred a nursing baccalaureate or an advanced nursing degree and possess a minimum of six (6) months of case management experience within the preceding thirty six (36) months
  

• Possess and maintain a current certification from one of the following accredited organizations: • 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) • 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) *OR* Possess a Master’s Degree in Nurse Case Management from a program acceptable to the Navy. The HCW is required to obtain any one of the above certifications within 6-months of contract start.

• Possess a minimum of one year full-time experience as a Registered Nurse in a primary care setting
  
• Possess the necessary knowledge, skills, aptitude, and computer literacy to evaluate, interpret, utilize and apply medical care criteria, such as InterQual, Milliman & Robertson Care Guidelines, Predictive Modeling and Integrated Medical Management Techniques in performance of the task requirements.
  
• Provide two letters of recommendation written within the preceding two years from practicing providers, supervisors or program administrators attesting to the HCW’s professional skills, competencies, patient rapport, training abilities, etc. Recommendation letters must include; name, title, phone number, date of recommendation, address and signature of the individual providing the recommendation.
• HCW shall be in good standing, and under no restrictions, with the state licensure board in any state in which a license is held or has been held within the last 10 years.
  
• HCW shall be in good standing and under no sanction or suspension by the Federal Government.
  
• Possess and maintain current certification in either the American Heart Association BLS for Healthcare Providers or American Heart Association Healthcare Provider Course.
  
• Able to read, write, speak, and understand the English language fluently and maintain good communication skills with patients and other health care personnel.
  
• Ability to pass all background/suitability checks.
  
• A valid driver’s license; ability to travel locally as needed.

Preferred Qualifications:

• A thorough understanding of the military lifestyle and experience working with military family members.
  
• Working knowledge of relevant military, state, federal, and local laws and resources.
  
• Highly developed written, oral, and presentation communication skills

Pay and Benefits
At Goldbelt, we value and reward our team's dedication and hard work. We provide a competitive base salary commensurate with your qualifications and experience. As an employee, you'll enjoy a comprehensive benefits package, including medical, dental, and vision insurance, a 401(k) plan with company matching, tax-deferred savings options, supplementary benefits, paid time off, and professional development opportunities.