RN Case Manager: Care Coordination Expert

Ouzinkie Native Corporation; Colorado Springs (CO); On-site; USD 65,000 - 90,000; Full time

Job summary

Ouzinkie Native Corporation is seeking a BSN-credentialed Case Manager to coordinate healthcare services for TRICARE/Medicare beneficiaries. The role requires collaborative work with military and civilian providers and use of UM systems to manage high-risk patients.

Responsibilities include eligibility determinations, care coordination, multidisciplinary treatment planning, and comprehensive recordkeeping. A current US nursing license and BLS are required.

Qualifications

• BSN from a NLN or AACN accredited college or university as delineated by Headquarters United States Air Force Surgeon General.
• At least three years of medical or surgical experience and at least one year in Case Management.
• Active, unrestricted US nursing license (including NLC/eNLC) or a license from any US jurisdiction; current and in good standing.
• Current state nursing license in good standing.
• Extensive knowledge of TRICARE, Medicare/Medicaid benefits.
• Experience with pediatric, adult and geriatric case management assessment.
• Proficiency with basic office automation and information management tools.
• Current BLS healthcare provider certification.
• Credentialing and site health screening requirements must be maintained.
• Ability to obtain required security access/background checks.

Responsibilities

• Coordinate healthcare coordination and case management services for TRICARE/Medicare beneficiaries within MTF.
• Collaborate with military and civilian healthcare providers; use UM system support to identify high-risk/high-cost patients.
• Determine eligibility for coordination/case management services.
• Coordinate with providers to ensure appropriate appointment alternatives, access and quality of care.
• Develop multidisciplinary treatment plans addressing identified conditions and needs.
• Maintain patient records and report monthly care summaries to MM or designee.
• Attend discharge planning conferences and contribute to education and competency of staff.

Skills

Oral communication

Written communication

English proficiency

Interpersonal skills

Team collaboration

Time management

Education

BSN from NLN/AACN accredited program

Tools

Utilization Management systems

Office automation (word processing, databases, email)

Job description

Ouzinkie Native Corporation is seeking a BSN-credentialed Case Manager to coordinate healthcare services for TRICARE/Medicare beneficiaries. The role requires collaborative work with military and civilian providers and use of UM systems to manage high-risk patients.

Responsibilities include eligibility determinations, care coordination, multidisciplinary treatment planning, and comprehensive recordkeeping. A current US nursing license and BLS are required.