Nurse (Case Management)

Indian Health Service; Dulce (NM); On-site; USD 75,000 - 95,000; Full time

Job summary

Indian Health Service, Jicarilla Service Unit in Dulce, NM, seeks a Nurse (Case Management) to coordinate care for patients with chronic conditions and develop skills in comprehensive assessment and care planning. The role reports to the Chief Nurse Executive or designee and requires active RN licensure and relevant case management experience.

The incumbent will perform well-established case management activities, coordinate referrals, and monitor service timeliness, ensuring appropriate care

Qualifications

• RN license required and active in-state or compact license.
• Bachelor's degree in nursing (BSN) or equivalent diploma/degree.
• Experience in case management and coordinating care for chronic conditions preferred.

Responsibilities

• Review outpatient consultations/referrals to determine eligibility and priority.
• Monitor resources and justify services requested for referrals.
• Keep chart reviews to ensure timeliness of services and return to service unit.
• Assist and plan the clinical component of managed care and utilization management.

Skills

Case management

Nursing assessment

Care coordination

Referral review

Education

RN license

BSN or nursing degree

Job description

This position serves as the Nurse (Case Management) at the Jicarilla Service Unit, Dulce, NM. The incumbent provides well-established case management activities, coordinates care for patients with chronic and recurring health conditions and develops nursing skills in comprehensive assessment and care planning. This position reports to the Chief Nurse Executive or designee. A REAL ID will be required beginning May 7, 2025, in accordance with 6 C.F.R. 37.5 (2021).

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. Individual Occupational Requirements NOTE: Employees currently assigned to positions in this occupational series as of September 2017 will be considered to have met the basic requirements for the position occupied. BASIC REQUIREMENT(S): Education 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(external link), Council on Accreditation of Nurse Anesthesia Educational Programs(external link), Accreditation Commission for Midwifery Education(external link), or an accrediting body recognized by the U.S. Department of Education(external link) at the time the degree was obtained. Degree from Foreign Nursing School: Official certification from the Commission on Graduates of Foreign Nursing Schools (external link) is required for individuals who graduated from foreign nursing schools.

Licensure

For all grade levels and positions, applicants must have passed the National Council Licensure Examination(external link). In addition, they 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.

Experience

The work experience must have equipped the applicant with the particular knowledge, skills, and abilities to successfully perform the duties of the position. At the GS-9 and above grade level, many positions may require experience in a specialty area of nursing. In addition to the above requirements, applicants must meet one of the following requirements: Basic Requirements for the GS-9 (or equivalent) Grade Level In addition to the above requirements, applicants must meet one of the following requirements: Possession of a master's degree in professional nursing; or At least one full year of professional nursing experience (equivalent to the GS-7 grade level or above) and possession of a diploma, associate degree, or bachelor's degree in nursing from a professional nursing program.

• Review outpatient consultations/referrals to determine if referral meets established criteria of current priority level
• monitor for alternate resources available
• justification for services requested
• and appropriateness of referral request

Maintain system for tracking referred patients for admission to other healthcare facilities and performs chart reviews to determine timeliness of requested service to facilitate the return of patients to the service unit.

Basic Requirements for the GS-11 (or equivalent) Grade Level

Successful completion of a PhD or equivalent doctoral degree from a professional nursing educational program or related medical science field; OR At least one full year of professional nursing experience (equivalent to the GS-9 grade level) and possession of a diploma, associate degree, bachelor's degree, or master's degree from a professional nursing educational program.

• Assisting and planning the coordination of the clinical component of managed care.
• Provide clinical and administrative recommendations relative to programs, committees and/or services that relate to fee senders and utilization management of patient referrals.

You must meet all qualification requirements within 30 days of the closing date of the announcement.