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Registered Nurse/Case Manager
at Jemez Pueblo
- Job ID
- # of Openings
- Health Care
Coordinate care with medical providers, nurses and other staff to ensure quality patient outcomes are achieved, through different levels of care, within established time frames and with efficient use of resources. Function as a contact person for patient, family, community resources and health care team members internal to JHHS and referred care outside of JHHS to ensure case management; discharge planning and continuity of care. Supervises Personal Care Attendants.
- Identifies, through Contract Health Services census review, referral and risk screening, appropriate patients requiring care coordination and case management. Assesses the patient/family needs in relation to the medical diagnosis, treatment and resources providing treatment options for continuity of care.
- Assesses patient level of function including developmental, physical, environmental, cognitive, behavioral, psychological, economic, social, cultural, and spiritual factors.
- Provides assistance to help patient recovery, understanding, discharge and/or management of an acute, chronic, or terminal condition; assistance may include education, referrals to JHHS clinic or community services, assistance with insurance coverage, acquisition of medical equipment, and information and referrals.
- Coordinates multidisciplinary care planning including patient care conferences to help resolve treatment decisions.
- Obtains necessary orders from medical providers to initiate home health referrals, personal care services, medical equipment, and continuity of care.
- Takes referrals for Personal Care Attendant (PCA) services and assigns the PCA worker with consideration of patient choice,
- Supervises PCA’s who do minor housework, laundry, food shopping, meal preparation, and assist with activities of daily living.
- Recommends selection of staff, trains staff and administers discipline as required.
- Establishes and maintains relationships with referral providers and hospitals.
- Identifies and qualifies patients for healthcare benefits and alternate resources.
- Serves as liaison between the community and Medicare, Medicaid, Veterans Administration, NM Health Insurance Exchange providers, medical services, private insurances, SSI, SSDI, state programs, and other applicable resources.
- Assists healthcare and other staff members to understand elements and requirements of Social Security Administration, Disability Determination Services and how to best help individuals with disabilities to obtain benefits.
- Collaborates with other departments such as Patient Registration, Medical Records, Billing, and Purchase/Referred Care, to update patient applications and information and to determine patient eligibility for care.
- Maintains compliance with established Pueblo and department policies and procedures, quality assurance, safety, environmental, infection control and complies with requirements of accreditation and regulatory agencies.
- Establishes and maintains appropriate network of professional contacts.
- Enhances professional growth and development through participation in educational programs, workshops, and trainings.
- Contributes to the overall quality of the unit’s service provision by developing and coordinating work teams and by reviewing, recommending and implementing improved policies and procedures.
- Represents the Pueblo with dignity, integrity, and a spirit of cooperation in all relationships with staff and the public.
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.
Education and Experience:
Licensed Registered Nurse in State of New Mexico or Master’s degree in Social Work or a related field ; AND four (4) years of professional level discharge planning or casework experience in an ambulatory or acute care medical setting. .
Required Knowledge and Skills
- Methods and techniques of medical case management and care coordination. Community resources and programs.
- Laws, codes and regulations related to the work.
- Record keeping and report writing principles and practices.
- Techniques for dealing with a variety of individuals from various socio-economic, ethnic and cultural backgrounds, in person and over the telephone, often where relations may be strained.
- Health care insurance and benefits.
- Analyzing, interpreting and applying complex laws, codes, regulations and procedures.
- Assessing cases appropriately and utilizing the most appropriate community and welfare resources to provide effective client services.
- Organizing own work, setting priorities and meeting critical deadlines.
- Using initiative and independent judgment within established procedural guidelines.
- Preparing clear and concise reports, correspondence and other written materials.
- Contributing effectively to the accomplishment of team or work unit goals, objectives and activities.
- Using tact, discretion and prudence in dealing with youth and families contacted in the course of the work.
- Dealing successfully with a variety of individuals from various socio-economic, ethnic and cultural backgrounds, in person and over the telephone, often where relations may be confrontational or strained.
- Using software applications related to assigned functions.
- Communicating effectively in oral and written forms.
REQUIRED CERTIFICATES, LICENSES, AND REGISTRATIONS:
- Valid New Mexico Driver’s License.
- Bachelor’s Degree of Science in Nursing or Master’s Degree in Social Work
PHYSICAL DEMANDS & WORKING ENVIRONMENT:
The physical demands described herein are representative of those that must be met by an employee to successfully perform the essential functions of the job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Mobility to work in a typical office setting and use standard office equipment; stamina to sit for extended periods of time; strength and agility to lift and carry up to 20 pounds; vision to read printed materials and a computer screen, and hearing and speech to communicate in over the telephone and in person.