Job Details

Nurse | Social Worker Case Manager - ED/MH

Location:	Tuba City, AZ Exit Disclaimer: You Are Leaving www.ihs.gov
Type:	Tribal
Salary Range:	$39 to $60 / Per Hour
Open Period:	2/28/2025 to 3/28/2025
Summary:	TCRHCC is continuously challenged to meet the needs of a growing population, to keep pace with perpetual advances in medical knowledge and technology, and to deal with limited space – very close quarters. We are bursting at the seams and looking toward the future with hopes and dreams of all new facilities, in order to always deliver the best healthcare – the healthcare you deserve! 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 staff The 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 Social Worker/Registered Nurse (RN) Case Manager for TCRHCC and Sacred Peaks Healthcare Center (SPHC) and is responsible for direct supervision and supportive contact for the specific group of identified high-risk patients in the Emergency Department. The Social Worker/RN Case Manager is responsible for designing and managing a continuum of care focusing on empowering clients to achieve demonstrable outcomes and self-sufficiency. The Social Worker/RN Case Manager is responsible for assessment, service planning, and resource acquisition, monitoring progress and initiating and responding to emerging client needs. The Social Worker/RN Case Manager will link the client with Community Social Service providers, health care providers, substance abuse, and mental health providers to achieve specific goals. The Social Worker/RN Case Manager is responsible for utilization review of patient cases in the Emergency Department, , and will review of medical necessity of referrals to specialty providers for services not normally provided within the TCRHCC facility. The incumbent will work with the inpatient Case Management team to promote the efficient and effective use of a variety of health care resources by focusing on the whole patient to provide a seamless continuum of care. The goals are the provision of quality care, decrease the fragmentation of care, enhancement of patient self-care and quality of life, and cost containment. The incumbent will work closely work with Providers, Nurses, Social Workers, Physicians, the PRC department, and all health care providers staff at TCRHCC to ensure implementation of appropriate resources in the fulfillment of utilization goals for the hospital and third-party payors. The Social Worker/RN Case Manager will be responsible to the Director of Case Management/Care Coordination.
More info about area:	https://tchealth.org/ Exit Disclaimer: You Are Leaving www.ihs.gov
Duties:	Education: MSW Social Worker: • Master's Degree in Social Work (MSW), OR RN Case Manager: • Associates degree in Nursing, must obtain bachelor's in nursing within 2 years of hire. License/Certification: • Must have and maintain current Basic Life Support (BLS) certification by the American Heart Association throughout employment MSW Social Worker: • Licensed Master Social Worker (LMSW). If none, must obtain with two (2) years of hire. If unsuccessful, will result in termination of employment based on policy and necessary qualifications for the position. RN Case Manager: • A valid, current, full and unrestricted Professional Nursing License to practice nursing in any state of the United States of America, The Commonwealth of Puerto Rico, or a territory of the United States Experience: • Must have a minimum of one (1) year of experience in the clinical / mental health care setting • Must have a minimum of one (1) year experience in the clinical Emergency Department care setting • Experience and knowledge of discharge planning, case management, or utilization review processes. • Demonstrate knowledge of electronic health record systems. • Demonstrates proficiency in clinical case management, conducting comprehensive assessments, and utilizing effective critical thinking skills both in writing and verbally.
Qualifications:	1. Coordination of service specific assessments, service planning and enrollment 2. 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). 3. Comprehensive and client centered service planning and coordination 4. Works proactively with the established RN Case Managers and Social Workers of TCRHCC as a team member for care coordination of the patient populations served by TCRHCC 5. Resource acquisition facilitated referrals and linkages. 6. Consistent and on-going case consultation with all direct service providers 7. Developing and maintaining internal and external resource relationship 8. Service monitoring and following up to ensure continuity of care and updating of the client service plan 9. Identifies patient through consultation and high-risk diagnoses (i.e., COPD, CHF, DM) 10. Perform UR coordination functions by ensuring medical necessity of preadmission, admission, continued stay, cost containment and discharge planning on patients admitted TCRHCC as part of the ED Throughput. 11. Accountable for the education, knowledge and process related to the Recovery Audit Contractors role in inpatient and outpatient reimbursement as related to the impact on TCRHCC revenue. 12. Reviews TCRHCC inpatient admissions for medical necessity and is the lead for UR Committee reviews in collaboration with the Medical Staff representative. 13. Assists with the development of department reports, policy/procedures manuals, and program objectives 14. Assists with special projects as assigned 15. Conducts system and procedural efficiency evaluation to determine progress, performance, and conformity with program requirements 16. Assist in managing outpatient referrals for Purchased Referred Care (PRC) 17. Follow up outside inpatient referrals for continued follow up ( i.e., appointments and PHN referrals) 18. Will provide coverage for the inpatient units-ACU, PEDS, ICU, OB, and ER to include Outpatient Clinics. Manages care of prioritized TCRHCC/SPHC outpatient/inpatient based upon consultation from providers within the TCRHCC/SPHC healthcare delivery system; provides a consistent and on-going consultation with service providers. 19. Other Essential Functions listed on TCRHCC Careers page.
Work Type:	Permanent, Full
Announcement #:	2025 - 2841
Who May Apply?	All Groups of Qualified Individuals
Get Details & Apply:	https://careers-tchealth.icims.com/jobs/2841/ed--mh-nurse-case-manager-%28dh2103%29/job?mode=view Exit Disclaimer: You Are Leaving www.ihs.gov

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Name:	Yellowhorse, Tasheena