Location: Tuba City, AZ Exit Disclaimer: You Are Leaving www.ihs.gov
Type: TribalSalary Range: $33 to $52 / Per Hour Open Period: 1/19/2024 to 6/28/2024 Summary: LOCATION AND LIFESTYLE:• Live and work on the beautiful Navajo Reservation, near national parks and forests, canyon country, ski area a day trip away• The unique community of Tuba City offers a culturally rich environment and a rewarding career in an underserved area• Easy drive to Grand Canyon, Lake Powell, Snowbowl ski area, Las Vegas• Easy access to hiking, biking, fishing, skiing• Excellent work/life balance• Very close, collaborative professional staffThe unique community of Tuba City offers a culturally rich environment. The Native American tribes located and served here are the Navajo, Hopi, and Southern Paiute. This mixture along with Anglo, Hispanic, and African American employees of the hospital and school systems make a pleasantly diverse community.
Incumbent serves as an Outpatient/Inpatient Case Manager/Utilization Review Registered Nurse (CM/UR RN) for TCRHCC and is responsible for direct supervision and supportive contact for the specific group of identified patient assignments and high-risk patients. The CM/UR RN is responsible for designing and managing a continuum of care focusing on empowering clients to achieve demonstrable outcomes and self-sufficiency. The CM/UR RN is responsible for assessment, service planning, and resource acquisition, monitoring progress and initiating and responding to emerging client needs. The CM/UR RN performs Utilization Review and Management/Clinical Documentation Chart Reviews of patients in the acute clinical care setting, ambulatory care setting and will conduct UR reviews as required. The CM/UR RN will work closely with the Social Work (MSW) Case Manager on Discharge Planning and Care Transitions. The CM/UR RN will work closely with the Physician Advisor and participate on the UR Committee as well as conduct Clinical Documentation Chart Reviews related to peer review, financial or insurance determination, or claims denials. The CM/UR RN will link the client with Community Social Service providers, health care providers, substance abuse, and mental health providers to achieve specific goals. The CM/UR RN will have experience working with culturally diverse low-income populations having multiple barriers to self-sufficiency such as: illiteracy, welfare dependency, domestic violence, substance abuse, and mental health issues. The CM/UR RN will work with a multidisciplinary team within the service delivery setting. The CM/UR RN will be committed to Case Management Services and have some collaboration with Purchased and Referred Care (PRC) formally known as Contract Health Services, providing assistance with the PRC Case Specialist. The CM/UR RN will be responsible to the Director of Care Coordination. More info about area: https://www.facebook.com/tchealth Exit Disclaimer: You Are Leaving www.ihs.gov
Duties: 1. Adheres to most current ACMA Case Management Standards of Practice and Scope of Services2. Adheres to ANA Nursing Scope and Standards of Practice3. Adheres to most current ANA The Code of Ethics for Nurses4. Coordination of service specific assessments, service planning and enrollment. 5. Works with all facets of the Case Management continuum, i.e., social support, alternate resources, community referrals, discharge planning, Nursing Home/Skilled Nursing Placement and resource utilization. 6. Comprehensive and client centered service planning and coordination7. Works proactively with the established RN Case Managers/ Social Workers of TCRHCC as a team member for care coordination of the patient populations served by TCRHCC. 8. Resource acquisition facilitated referrals and linkages.9. Consistent and on-going case consultation with all direct service providers.10. Developing and maintaining internal and external resource relationship.11. Service monitoring and following up to ensure continuity of care and updating of the client service plan12. Identifies patient through consultation and high-risk diagnoses, i.e. COPD, CHF, DM13. Assists with the development of department reports, policy/procedures manuals, and program objectives14. Assists with special projects and reports as assigned.15. Conducts system and procedural efficiency evaluation to determine progress, performance, and conformity with program requirements. 16. Follow up outside inpatient case management referrals for continued follow up, I.E., appointments and PHN referrals. Will provide case management coverage for the inpatient units and case management referral follow up for the outpatient clinics. Will prioritize TCRHCC/SPHC outpatient/inpatient case management based upon referrals from providers within the TCRHCC/SPHC healthcare delivery system and high-risk assessment conducted on inpatient population. Will provide a consistent and on-going collaboration through communication with service providers. Facilitates appropriate clinical documentation to ensure that the level of services and acuity of care are accurately reflected in the medical record. 17. Improves the overall quality and completeness of clinical documentation by performing admission/continued stay clinical reviews using clinical documentation enhancement guidelines for selected patient populations. Qualifications: Education:• Associates Degree in Nursing (ADN), must obtain bachelor's in nursing within two (2) years of hire • License/Certification:• Must have and maintain current Basic Life Support (BLS) certification by the American Heart Association (AHA) throughout employment • A valid, current, full and unrestricted Professional Nursing License to practice as a Registered Nurse (RN) in any state of the United States of America, The Commonwealth of Puerto Rico, or a territory of the United StatesExperience:• Three (3) years of clinical nursing experience performing direct patient care with at least 2 years in an Inpatient setting on a medical-surgical unit, PACU, or higher acuity Inpatient unit (ICU, Step-Down, Telemetry, etc.) or home health (direct care) {clinical experience qualification may be determined by hiring manager/director.}• Demonstrate knowledge of the case management, purchased referred care and utilization review processes.• Demonstrate knowledge of electronic health record systems.Other Skills and Abilities:A record of satisfactory performance in all prior and current employment as evidenced by positive employment references from previous and current employers. All employment references must address and indicate success in each one of the following areas:• Positive working relationships with others• Possession of high ethical standards and no history of complaints• Reliable and dependable; reports to work as scheduled without excessive absences• Effective verbal & written communication skills• Team management focus promoting a positive and pro-active approach to problem resolution Work Type: Permanent, Full Announcement #: 2023-2595 Who May Apply? All Groups of Qualified Individuals Get Details & Apply: https://careers-tchealth.icims.com/jobs/2595/nurse-case-manager-utilization-review/job?mode=view Exit Disclaimer: You Are Leaving www.ihs.gov