Nurse (Case Management)

Full Job Description

This position is located in the Purchased/Referred Care (PRC) Department at the Jicarilla Service Unit.

The role provides clinical case management support to the PRC Program by coordinating healthcare services among inpatient and outpatient care teams, external providers, and PRC to ensure timely and appropriate patient care.

The position operates under the supervision of the Supervisory Nurse.

USAJOBS Help Center - Update your resume now so it meets new resume requirements To qualify for this position, your resume must state sufficient experience and/or education, to perform the duties of the specific position for which you are applying.

Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religious; spiritual; community; social).

You will receive credit for all qualifying experience, including volunteer and part time experience.

You must clearly identify the duties and responsibilities in each position held and the total number of hours per week.

BASIC REQUIREMENT(S): A graduate or higher level degree, bachelor's degree, associate degree, or diploma from an accredited professional nursing educational program is required.

This education must have been accredited by the Commission on Collegiate Nursing Education, Council on Accreditation of Nurse Anesthesia Educational Programs, Accreditation Commission for Midwifery Education, or an accrediting body recognized by the U.S.

Department of Education at the time the degree was obtained.

Degree from Foreign Nursing School: Official certification from the Commission on Graduates of Foreign Nursing Schools is required for individuals who graduated from foreign nursing schools.

AND Licensure: For all grade levels and positions, applicants must have passed the National Council Licensure Examination.

In addition, you must possess a current, active, full, and unrestricted license or registration as a professional nurse from a State, the District of Columbia, the Commonwealth of Puerto Rico, or a territory of the United States.

In addition to the Basic Requirements, you must also meet the Minimum Qualifications stated below.

MINIMUM QUALIFICATIONS: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the next lower grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Examples Include: Serving as Clinical Liaison and Case Manager to coordinate and manage referrals for primarily uninsured and referral patients.

Facilitates communication between clinical teams and outside agencies, conducting comprehensive assessments, and developing individualized care plans.

Manages case consults, coordinating with service unit case managers and discharge planners, and arranging for discharge when services are no longer required.

Knowledge of Purchase Referred Care regulations and interdisciplinary care planning. You must meet all qualification requirements within 30 days of the closing date of the announcement. Major Duties:

Total Compensation Package - Check out IHS's outstanding total compensation package for this job: Registered Nurse Total Compensation | Pay (ihs.gov) Coordinate and manage patient referrals and case management services by reviewing referrals daily, assigning medical priority ratings, and ensuring timely and appropriate care coordination for primarily uninsured patients.

Serve as a clinical liaison and resource for healthcare staff and providers, facilitating communication regarding referrals, clarifying provider orders, and collaborating with interdisciplinary care teams to ensure continuity of care.

Conduct patient intake, screening, and comprehensive assessments to evaluate medical, functional, psychosocial, financial, and environmental factors; develop care recommendations and coordinate treatment plans with providers, patients, and families.

Develop and implement patient care and service plans by coordinating with internal and external providers, obtaining prior authorizations, arranging services, monitoring care plan effectiveness, and maintaining accurate electronic documentation and program reports.

Manage complex patient cases and transitions of care, collaborating with hospitals, social workers, and community agencies to ensure cost-effective services, appropriate discharge planning, and access to local, tribal, state, and federal resources.