RN Case Manager

2 weeks ago

Smyrna, United States WJM Professional Services LLC Full time


Non-Clinical RN Case Manager


The Texas Army National Guard has contracted with WJM for the purpose of providing non-clinical medical and dental case management and administration services in support of Individual Medical Readiness (IMR) to include identification and tracking of Soldiers who are not Fully Medically Ready (FMR). This includes Periodic Health Assessment (PHA) support, Soldier Readiness Processing (SRP) support, and Soldier Readiness Certification (SRC) support. Contractor’s service is designated as Non-mission Essential Personnel.

The non-clinical nurse case manager requires the expertise as dictated by the 'practice of nursing" - the systematic application of substantial specialized knowledge and skills derived from the biological, physical, and behavioral sciences, to the care, treatment, counsel, and health teaching of individuals who are experiencing changes in the normal health processes or who require assistance in the maintenance of health and the prevention or management of illness, injury, or disability.

Qualifications:

  • Shall be a graduate with an Associate (ADN) or Baccalaureate (BSN) degree from a nationally accredited nursing institution
  • Minimum of 1-year broad-based clinical nursing experience
  • Active and unrestricted Registered Nurse license from any U.S. jurisdiction
  • Active BLS certification by the American Heart Association
  • Must have a valid driver’s license, state-mandated automobile insurance, and reliable transportation
  • Ability to effectively communicate and collaborate with a diverse group of people
  • Excellent written communication skills to ensure accurate documentation, both written and electronic
  • Proficient in Microsoft Word and Excel programs and the ability to learn/adapt to new computer systems
  • Experience utilizing eCase, DENCLASS, HRR, MEDPROS, SPL, LOD, and AVS preferred

Performance Requirements

The Case Manager will work with their Case Management Support team and other designated representatives to ensure the following job duties are completed accurately and efficiently:

  • Resolve and manage non-medical ready status by returning soldier to medically ready status or forward records to a Fitness for Duty Board for Soldiers in a non-medically ready status.
  • Maintain Health Insurance Portability and Accountability Act of 1996 (HIPAA) standards and guidelines for all health information obtained and used in performing this contract.
  • Perform initial interviews regarding deployment-limiting conditions for Soldiers in a non-medically ready status.
  • Obtain a signed copy release of information form for Soldiers in a non-medically ready status.
  • Review and validate treatment plans for Soldiers in a non-medically ready status.
  • Submit case processing, medical documents, and profile concerns to the military provider for assigned cases.
  • Coordinate soldier treatment plans with appropriate medical facilities for assigned cases.
  • Request profile exams/evaluations and audio exams with appropriate medical facilities through the specified military POC for appropriate cases.
  • Track medical appointments by communication and coordination with the unit to ensure Soldier attendance and submission of follow-up documentation for all assigned cases.
  • Manage soldiers with T3, T4, P3, and P4 profiles and other identified cases in the eCASE module for all assigned cases.
  • Attend PHA/FMR/SRP events as determined by the COR for cases as assigned.
  • Review and track health assessment (PHA, SRP) lab results for all assigned cases.
  • Log any contact with Soldier for all assigned cases.
  • Run and monitor MEDPROS report post-event for all PHA/SRP events.
  • Communicate all requests for medical information to medical records room for soldiers who request medical information.
  • Prepare and maintain medical board packets throughout the entire medical board determination process for non-medically ready soldiers.
  • Prepare all required medical and administrative documents required for medical evaluation for soldiers identified for board proceedings.
  • Monitor packets in CMS-MODS throughout the evaluation process until completion.
  • Resolve and communicate in regards to identified board packets.
  • Provide and communicate administrative documents and/or final results for the board to the Soldier, Unit Commander, and COR or designated representative for soldiers in board proceedings.
  • Document all cases in the electronic medical file for all soldiers referred for case management.
  • All cases, regardless of type (medical/dental) or duration, must be documented in MEDCHART eCase module. This includes medical information and communication that is relevant to soldier’s condition.
  • Update MODS/MEDPROS with all relevant medical/dental documentation received for all assigned cases.
  • Monitor individual medical readiness to ensure all scheduled services are completed, updated and the current medical status is reflected in MEDPROS for all assigned cases.
  • Review all cases at a quarterly team meeting or as requested to update the COR for all cases in progress.
  • Identify and maintain a list of available local resources to ensure Soldiers have alternative options available to receive medical or dental care for soldiers not eligible for military health benefits.
  • Educate soldiers on resources available to improve medical and dental readiness for all assigned cases.

Work Hours & Locations

  • Camp Mabry, Austin, TX and occasionally at other armories located in Texas
  • Your normal work schedule will align with the requirements of the contract and normally will be 8.5-hour days, Monday through Friday, except Federal holidays. All schedules include a 30-minute non-paid meal break. Employees are required to be available during the core hours of 0900 to 1500 hours daily. Flextime must be approved in advance by your Program Manager and cannot start earlier than 0600 or later than 0900. Special events may require working outside of the normal work schedule and include weekends.

Physical Demands

  • This position requires sitting, standing, walking, bending, kneeling and stooping. An employee may frequently lift and/or move items over 25 lbs.

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