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Rn Case Manager

Posted By:
OMV Medical
Posting ID:
Newport, Ri
301 270 9219
 nurse   case   manager   nursing   management 
Category:Medical / Health
Listing Type:Job
Employment:Full Time
Company:OMV Medical, Inc

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This position will support the Managed Care Department at Naval Branch Health Clinic, Newport, RI.


Possess education as follows: Either
o (a), a Baccalaureate Degree in Nursing; or
o (b) a Diploma Graduate in Nursing; or
o (c) an Associate Degree in Nursing.
Possess current unrestricted license to practice as a registered nurse in one of the fifty states, the District of Columbia, the Commonwealth of Puerto Rico, Guam, or the U.S. Virgin Islands.
Possess a minimum of 12 months experience managing and overseeing a case management program.
Provide two letters of recommendation written within the last two years attesting to the health care workers clinical skills. A minimum of one letter must be from a supervisor. Reference letters must include name, title, phone number, date of reference, address and signature of the individual providing the reference.

Must possess at least one of the qualifications given below:
Possess current certification in a minimum of one of the following:
(a) Certified Case Manager (CCM) issued by the Commission for Case Manager Certification or
(b) Certified Disability Management Specialist (CDMS) issued by the Certification of Disability Management Specialists Commission or
(c) Certified Rehabilitation Registered Nurse (CRRN) issued by the Association of Rehabilitation Nurses or
(d) Certified Occupational Health Nurse (COHN) issued by the American Board for Occupational Health Nurses or
(e) Advanced Certification in Continuity of Care (ACCC) issued by the National Board for Certification in Continuity of Care or
(f) Certified Rehabilitation Counselor (CRC) issued by the Commission on Rehabilitation Counselor
Certification or
(g) Nurse Case Manager (RN-NCM) issued by the American Nurses Credentialing Center
(h) Care Manager Certified (CMC) issued by the National Academy of Certified Care Managers
Possess a minimum of2 years full-time experience within the last 3 years as a registered nurse providing case management and obtain one of the certifications above within 24 months of commencing service under the contract
Possess a Master's degree in Nurse Case Management and obtain one of the above certifications within 24 months of commencing service under the contract.
Possess a valid driver's license and a personal vehicle for use under the contract.
Possess the necessary knowledge, skills and computer literacy to interpret and apply medical care criteria such as InterQual.


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 Lead Agent office, and the Managed Care Support Contractor.
Maintain adherence to JCAHO, Utilization Review Accreditation Commission (URAC), Case Management Society of America (CMSA) and other regulatory requirements. Apply medical care criteria (e.g., InterQua1).
Ensure accurate collection and input of patient care data and ensure basic CM budgetary management.
Oversee 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.
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 nursing advice and consultation in person and via telephone.
Ensure appropriate health care instruction to patient and/or caregivers based on identified learning needs.
Alert physicians to significant changes or abnormalities in patients and provide information concerning their relevant condition, medical history and specialized treatment plan or protocol.
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.
Implement 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.
Facilitate screening and assist with transfers of Exceptional Family Member Program (EFMP) families.
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.
Establish cost containment/cost avoidance strategies for case management and develop mechanisms to measure its cost effectiveness.
Assist with the CHCS and/or AHL TA CM interface or other database designed to support CM.
Participate in video teleconferences (VTCs) and other meetings as required.
Travel to training, meetings, or conferences, as assigned by the supervisor or Commanding Officer.

This is a long term contracting position with an excellent remuneration package and full benefits including health care and paid vacations and holidays. If you would like to pursue this opportunity please email your or call Sandra on 301 270 9219.

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