RN Case Manager (Non-Supervisory)

3. Appropriately triages referrals according to medical necessity. Must be able to accurately assess the criticality of need within 24 hours of referral. If patient needs urgent services, must be able to direct Care Coordinator and/or the Patient Advocate to coordinate care for patient in these situations.

4. Works collaboratively with patients, families, medical providers, nurses, Tribal entities, and all members of the multidisciplinary healthcare team to provide high quality and patient-driven care.

5. Collaborates and communicates with patients, families, support networks, and health care professionals to establish and implement the plan of care.

6. Documents patient progress in NextGen electronic health record (EHR) related to the plan of care, including charting referrals, home visits and other notable interactions.

7. Evaluates patient progress using nationally/local recognized guidelines at established intervals, and as needed, while collaborating with the multidisciplinary care team to adjust the plan of care to improve outcomes.

8. Documents intake information, reassessment information, referrals, case reports and home visits within the EHR.

9. Determines the need for medical, therapeutic, psycho-social, or psychiatric evaluations based on patient progress. May initiate referrals based upon IHC standardized protocols in collaboration with the medical team.

10. Coordinates and provides patient care based on an approved treatment plan.

11. Ensures that patients are active participants and decision makers in their treatment plan, answering any questions they may have.

12. Determines case closure by evaluating patient progress toward established goals.

13. Builds strong relationships with various health care discipline teams throughout the case management process.

14. Assists patients and families with necessary financial assistance referrals and eligibility determination.

15. Establishes and provides ongoing communication between SIHC and patients who would benefit from referral to community social resource agencies.

16. May be tasked to cover RN clinical duties, in SIHC at both clinics (Alpine and Campo) during critical staffing shortages.

17. Communicates care plan to chain of command as appropriate. Seeks guidance in challenging clinical situations.

18. Other duties as assigned.

19. This position may require working weekends and evenings as needed.

Qualifications

Education/Experience

Must possess a current California Registered Nurse license. A minimum of 3 years’ experience in a similar healthcare role. Must have knowledge and understanding of HIPAA in the ambulatory care setting, with absolute ability to maintain confidentiality according to standards. Must possess current CPR; ACLS must be obtained in the first four weeks of employment.

License

A valid driver’s license is required at the time of appointment and must be maintained throughout employment. Applicants must be insurable under SIHC vehicle insurance policy at the time of hire and throughout employment. Certifications and/or licenses appropriate to the positions required education and profession must also be valid and maintained.

Character

Applicants must have a reputation for honesty and trustworthiness. Must be responsible and able to exercise good judgment, accept administrative supervision, follow detail, including the ability to interact effectively and communicate with people in a professional and courteous manner. Must be highly confidential and work as a team with other staff. Must exhibit cultural and community awareness and sensitivity.

Skills

Strong team building, interpersonal, and organizational skills. Ability to establish and maintain effective peer relationships with coworkers within the Department, clinic-wide, and the public. Must be able to express ideas clearly, concisely, address audiences effectively, and exercise balanced judgment in evaluating situations and making decisions. Willing to be part of a team and cooperate in accomplishing department goals and objectives. Ability to prioritize, meet deadlines, take initiative, be proactive, and function in a rapidly changing environment. Ability to work with people of all social and ethnic backgrounds and to resolve conflicts, negotiates situations, and facilitate consensus.

Physical and Personal Requirements

Normal clinic/office environment. Sit or stand for long periods of time. Reach, bend, climb, stoop, lift up to 25 lbs. repetitive hand movement; use and view PC. Reliable transportation and car insurance as required by the state. Travel as needed.

Compliance

Each employee plays a key role in creating a compliance culture at SIHC. Employees are expected to learn and comply with all SIHC policies and procedures. One must have the ability to understand the implications and complexities of all compliance policies. Participation in all compliance training is mandatory, and generally has a heightened awareness of policies and regulations that are specific to one’s department and position. All SIHC employees are expected to report violations or suspected violations of compliance policies or regulations.

Other

Applicants must successfully pass a pre-employment physical exam, tuberculin skin test or x-ray, and blood/urine/drug screening test. Health must be adequate to perform all duties of the position.

Indian preference

In the filling of any SIHC job vacancy, preference may be given to qualified Native American Indians, pursuant to the Indian Preference Hiring Act, 25 USC 472, unless other laws require the filling of a vacancy without regard to Indian preference (e.g. Public Law (P.L.) 94-437, “Indian Health Care Improvement Act (IHCIA). To receive Indian preference for any SIHC position, the applicant must be enrolled, or be eligible for enrollment, as an American Indian with their Tribe, or must be certified as an American Indian from the designated Tribal Representative. Applicants claiming Indian preference must attach verification of their claim to the SIHC application, including Certification of form BIA-4432, which is available from the SIHC Human Resources Department. If verification is not or cannot be verified, the applicant will not receive Indian preference for purposes of the interview.