Job description

We are seeking Nurse Case Managers to work at the Brooke Army Medical Center (BAMC), in San Antonio, Texas. The Nurse Case Manager (NCM) will work within the Department of Quality Services, (DCQS) and/or Department of Surgery, (DOS).

Qualifications:

• Education. Associates Degree of Nursing. Graduate from a college or university accredited by Accreditation Commission for Education in Nursing (ACEN), the Commission on Collegiate Nursing Education (CCNE).
• Certifications: Possess one of the following:
• 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)

• Basic Life Support (BLS) Certification: Nurse Case Managers shall maintain current certification in Basic Life Support (BLS) from the American Heart Association, or the American Red Cross.
• Experience: Current experience requirement is three years of in the last four years as a registered nurse case manager.
• Licensure: Current, full, active, and unrestricted license to practice as a Registered Nurse.

Shifts/Work Schedule:

• Inpatient: The contractor and NCM will support the MTF’s seven-day a week, 365 days a year operation that includes an in-patient population and 24-hours a day. Shift lengths for NCM assigned to in-patient wards may vary by work area and can consist of 8, 10, and 12-hour shifts that will be combined so as to not to exceed 80-hours of work per 2-week period per each full-time requirement.
• Outpatient: Normal hours of operation for out-patient clinics are 7:30 a.m. to 4:30 p.m., Monday through Friday, but duty hours may also include 9 consecutive hours per day/40-hour work week, routinely scheduled between the hours of 0700 to 2100 hours, Sunday through Saturday excluding federal holidays with 1 hour unpaid lunch and some command-directed training holidays. Shift lengths for NCM assigned to out-patient clinics are 8 hours in duration with an unpaid lunch break of approximately one hour in duration.

Description of Work:

The NCM shall provide patient-centered, individual and family level case management services for all eligible beneficiaries of the Military Health System, as well as non-beneficiary civilian emergency patient during the inpatient episode of care. The case manager will work collaboratively with multidisciplinary hospital staff to coordinate and procure all necessary equipment and supplies for the patient's discharge.

• Manage patient care effectively through collaboration with the multidisciplinary team to develop a plan of care that would minimize medically unnecessary hospital admissions, re-admissions, emergency room and urgent care visits, ancillary care, and discharge planning. Achieve beneficiary and staff satisfaction at the highest-level possible with services provided. Timely transfers of patients to appropriate levels of care to reduce avoidable bed days. Reduction in healthcare expenditures through proactive coordination of post-hospitalization medical needs in concert with the multidisciplinary plan of care to facilitate medically appropriate length of stay and appropriate level of care.
• Provide NCM and discharge/disposition planning in inpatient and ambulatory care settings for beneficiaries as needed, with early identification and interventions focused on outcomes as defined herein.
• Accept referrals for NCM from all sources and perform initial assessment of each patient referred.
• Identify care options that are acceptable to the patient and family that lead to increased adherence to treatment plans, and improved healthcare outcomes.
• Monitor care delivery to the patient across the care continuum (for example sub-acute, long-term, home health, and hospice care) and document assessments of patient progress in reaching healthcare outcome goals.
• Collaborate with direct and purchased care systems to ensure a smooth transition for patients from one level of care or care setting to another, such as rehab, residential or other care institution.
• Ensure coordination of care delivery processes to enhance patient's health and wellness, safety, productivity, and quality of life, to include alternate care settings and the home environment.
• Coordinate discharge/disposition plans to meet the patient's post-hospitalization and post-acute care requirements, to include:

Level of care

Follow-up, and services determined by the physician

Types of medical equipment needed for in home and post-hospitalization use

Rehabilitation/ extended care placement

Other care arrangements, as necessary

• The NCM shall complete a thorough community assessment of available healthcare systems to include medical specialty services to identify agencies for the placement of patents for required medical support services.
• The NCM shall appropriately manage all patients selected for case management across the care continuum, following the CMSA Case Management Standards of Practice, Defense Health Agency (DHA) policies and MTF policies and procedures. Legal and ethical processes will be followed to ensure the patient's clinical, bio-psychosocial, safety, financial, cultural, and environmental healthcare needs are appropriately fulfilled in the most timely manner within the clinical setting where they are treated.
• The NCM shall expect surges in patient caseloads to occur during or following contingency operations. The increased caseload may be for short durations to provide care coordination in the way of discharge/disposition planning and possibly case management for Active-Duty Service Members (ADSMs) and, or to meet family needs of service members. Examples of unique military case management needs include, but are not limited to:
• Cases complicated by psychosocial/environmental factors (for example military personnel who reside in a barracks).
• Cases impacted by family/military circumstances (for example patient whose spouse is deployed, other children at home, and no other family support).
• Cases which require extensive monitoring and coordination (for example foreign military injured, those soldiers injured with no family, and requires assistance with DME and transportation to and from appointments, Physical Therapy (PT) daily, Coumadin clinic, or an elderly person who lives alone).
• All cases for ADSMs in an inpatient status in a civilian hospital.

• The NCM shall use available standardized forms, paper-based or electronic, for documentation of provision of services. Telephone call logs and files may be required to keep detailed documentation.
• Coding of ambulatory case management encounters is required at MTFs as a method of collecting specific population healthcare data and/or NCM interventions. The contract NCM shall use approved codes for all NCM encounters.
• The NCM shall provide NCM data and reports of workload as requested.

Core Duties:

• Participate in all phases of the Case Management Program (CMP) and ensure that the CMP meets established case management (CM) standards of care.
• 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 tools to support case management, such as those used for patient identification and patient assessment, clinical practice guidelines, algorithms, CM software, and databases for community resources.
• Integrate CM and utilization management (UM) and integrating nursing case management with social work case management.
• Maintain liaison with appropriate community agencies and organizations.
• Accurately collect and document patient care data.
• Develop treatment plans including preventive, therapeutic, rehabilitative, psychosocial, and clinical interventions to ensure continuity of care toward the goal of optimal wellness.
• Establish mechanisms to ensure proper implementation of patient treatment plan and follow-up post discharge in ambulatory and community health care settings.
• Provide appropriate health care instruction to patient and/or caregivers based on identified learning needs.

Job Types: Full-time, Contract

Pay: $40.00 - $45.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Holidays
• Monday to Friday
• Weekend availability

Work Location: In person

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