Nurse (PRC Case Management)

Indian Health Service; Albuquerque (NM); On-site; USD 85,000 - 105,000; Full time

Job summary

Indian Health Service in Albuquerque seeks a PRC Case Management Nurse to coordinate referrals, assess complex needs, develop care plans, and monitor services within a federal Native healthcare program.

You will work with multidisciplinary teams, patients and families to ensure timely access to Purchased/Referred Care and related resources, and maintain accurate records in a fast-paced environment.

Qualifications

• Registered Nurse with active/state license required.
• Experience coordinating patient care, referrals, and transitions in a healthcare setting.
• Knowledge of Purchased/Referred Care (PRC) requirements and community resources.

Responsibilities

• Review and prioritize patient referrals and coordinate care with IHS providers, outside healthcare facilities, and other programs to help patients receive appropriate and timely services.
• Provide case management for patients with complex healthcare needs, including assessing needs, developing care plans, monitoring services, addressing barriers to care, and coordinating follow-up.
• Coordinate referrals and transitions of care by working with healthcare teams, case managers, social workers, patients, families, and community partners.
• Assist patients with accessing needed services by obtaining prior authorizations, supporting insurance appeals, identifying available resources, and applying Purchased/Referred Care (PRC) requirements.
• Maintain accurate patient and referral information, track the status of referrals, participate in care team meetings, and identify ways to improve referral and case management processes.

Skills

Nursing

Case management

Referral coordination

Communication

Education

Bachelor of Science in Nursing

Job description

Summary

This position is located at the Albuquerque Service Unit in Albuquerque, NM. This position will serve as a PRC Case Management Nurse within the Indian Health Service.

A REAL ID will be required beginning May 7, 2025, in accordance with 6 C.F.R. 37.5 (2021).

Duties

• Review and prioritize patient referrals and coordinate care with IHS providers, outside healthcare facilities, and other programs to help patients receive appropriate and timely services.
• Provide case management for patients with complex healthcare needs, including assessing needs, developing care plans, monitoring services, addressing barriers to care, and coordinating follow-up.
• Coordinate referrals and transitions of care by working with healthcare teams, case managers, social workers, patients, families, and community partners.
• Assist patients with accessing needed services by obtaining prior authorizations, supporting insurance appeals, identifying available resources, and applying Purchased/Referred Care (PRC) requirements.
• Maintain accurate patient and referral information, track the status of referrals, participate in care team meetings, and identify ways to improve referral and case management processes.

Total Compensation Package

Check out IHS's outstanding total compensation package for this job:

Registered Nurse Total Compensation | Pay (ihs.gov)

Requirements

Conditions of employment

• Selectee may be subject to a probationary period
• U.S. Citizenship is required
• Selective Service Registration is required for males born after 12/31/1959
• This is a designated position covered by Public Law 101-630, requiring contact or control over Indian children. Due to this requirement, the agency must ensure that persons hired for these positions have not been found guilty of or pleaded nolo contendere or guilty to certain crimes.
• Successfully pass the E-Verify employment verification check. To learn more about E-Verify, including your rights and responsibilities, visit www.dhs.gov/E-Verify/.
• You will need to set up direct deposit so we can pay you.

Background Investigation Requirement

This position requires the successful completion of a federal background investigation as a condition of employment.

A background investigation is a standard process used by the Federal Government to verify an individual's identity, employment history, education, and other relevant information to determine suitability for Federal service.

Upon receipt of instructions, applicants must complete all required background investigation forms within five (5) calendar days of issuance. Timely completion is critical to avoid delays in processing or a determination of unsuitability.

Applicants are strongly encouraged to prioritize this requirement and to maintain regular communication with their assigned Personnel Security Specialist throughout the process.

Financial Suitability Requirement

This position requires a review of the applicant's financial history as part of the personnel security and suitability determination. Applicants must demonstrate financial responsibility, maintain good standing with creditors, and satisfy all legal financial obligations prior to applying.

Individuals with substantial delinquent or unresolved financial obligations-including, but not limited to, delinquent federal or state tax liabilities, defaulted federal student loans, court-ordered fines or fees, or child support arrears-may be deemed unsuitable for employment with the Indian Health Service (IHS).

Prior to the appointment, candidates must present two valid forms of identification. If one of the documents is a state-issued ID or driver's license, it must be REAL ID-compliant.

Qualifications

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)

Individual Occupational Requirements General Schedule Qualification Standards - Nurse Series 0610

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, 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. Must submit copy of transcript. Applications will be considered incomplete without proof.

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. Applications will be considered incomplete without proof.

Licensure

For all grade levels and positions, applicants must have passed the National Council Licensure Examination. 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. Must submit copy of nursing license that includes an expiration date. Applications will be considered incomplete without proof. In addition to the above requirements, applicants must meet one of the following requirements:

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;
• Your resume must demonstrate 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. Examples of experience include: Coordinating patient care and referrals between healthcare providers, outside facilities, and other programs to ensure patients receive appropriate and timely services. Experience includes reviewing and prioritizing referrals, assessing patient needs, developing and monitoring care plans, obtaining prior authorizations, coordinating transitions of care, and helping patients access available healthcare and community resources. Maintaining patient and referral records, working with interdisciplinary healthcare teams, and applying Purchased/Referred Care (PRC) requirements or similar healthcare program policies and procedures.

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

Education

This position has an education requirement. You are strongly encouraged to submit a copy of your transcripts or a list of your courses including titles, credit hours completed, and grades. Unofficial transcripts will be accepted in the application package. Official transcripts will be required from all selectees prior to receiving an official offer.

Only attendance and/or degrees from schools accredited by accrediting institutions recognized by the U.S. Department of Education may be credited. Applicants can verify accreditation at the following website: https://www.ed.gov/accreditation.

If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. For further information, visit https://sites.ed.gov/international/recognition-of-foreign-qualifications/.

The Indian Health Service (IHS), National Health Service Corps (NHSC), And The Health Resources And Services Administration (HRSA) Have Student Loan Repayment Programs For Qualifying Health Disciplines. This Is a Competitive Process Separate From The Hiring Process. Opportunities For LRP Are Based On Agency Hiring Priorities And Availability Of Funds. For Additional Information Please Visit

For IHS - http://www.ihs.gov/loanrepayment/

For NHSC - https://nhsc.hrsa.gov/loanrepayment/

For HRSA Nurse Corps - https://bhw.hrsa.gov/loansscholarships/nursecorps

Additional information

Reasonable Accommodation (RA) Requests:

If you believe you have a disability (i.e., physical or mental), covered by the Rehabilitation Act of 1973 as amended that would interfere with completing the USA Hire Competency Based Assessments, you will be granted the opportunity to request a RA in your online application. Requests for RA for the USA Hire Competency Based Assessments and appropriate supporting documentation for RA must be received prior to starting the USA Hire CompetencyBased Assessments. Decisions on requests for RA are made on a case-by-case basis. If you meet the minimum qualifications of the position, after notification of the adjudication of your request, you will receive an email invitation to complete the USA Hire Competency Based Assessments, based on your adjudication decision. You must complete all assessments within 48 hours of receiving the URL to access the USA Hire Competency Based Assessments if you received the link after the close of the announcement. To determine if you need a RA, please review the Procedures for Requesting a Reasonable Accommodation for Online Assessments. (https://appsupport-usastaffing.opm.gov/hc/en-us/sections/45063131363475-Reasonable-Accommodation-Information)

Federal Employees earn annual leave at a rate (4, 6 or 8 hours per pay period) which is based on the number of years they have served as a Federal employee. IHS may offer newly-appointed Federal employees credit for their directly related previous non-federal experience or active duty uniformed military service. This credited service can be used in determining the rate at which they earn annual leave.

This position is covered by a Bargaining Unit.

Recruitment or relocation incentives may be authorized. At least a 1 year service agreement will be required.

This position has no promotion potential.

You will be evaluated for this position in accordance with the OPM Merit Hiring Plan.

As part of the application process, you will be asked to provide short essay responses (200 words or less each) to the following four questions.

• How has your commitment to the Constitution and the founding principles of the United States inspired you to pursue this role within the Federal government?
• In this role, how would you use your skills and experience to improve government efficiency and effectiveness?
• In this role, you will be expected to professionally and efficiently implement executive direction. Provide an example where you implemented leadership direction on a strategy or policy decision that differed from your own recommendation.
• How has a strong work ethic contributed to your professional, academic or personal achievements?
• Your responses are optional and will not be scored.
• However, they may be reviewed by hiring managers and agency leadership (or designees) during the evaluation process.
• You will be asked to certify that your responses are written in your own words and that you did not use a consultant or artificial intelligence (AI) tool (such as ChatGPT or Copilot).

Candidates should be committed to improving the efficiency of the Federal government, passionate about the ideals of our American republic, and committed to upholding the rule of law and the United States Constitution.

A career with the U.S. government provides employees with a comprehensive benefits package. As a federal employee, you and your family will have access to a range of benefits that are designed to make your federal career very rewarding.

Open in a new window: Learn more about federal benefits.

Review our benefits

Eligibility for benefits depends on the type of position you hold and whether your position is full-time, part-time or intermittent. Contact the hiring agency for more information on the specific benefits offered.