Job Details
Nurse Case Manager
| Location: | |
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| Type: | Tribal |
| Salary Range: | $72,073 to $90,010 / Per Year |
| Open Period: | 5/14/2019 to 5/29/2019 |
| Summary: |
This position is within the Tohono O'odham Nation Health Care, to include Sells Hospital, San Xavier Health Center, Santa Rosa Health Center and San Simon Health Center, in the Division of Purchased Referred Care as assigned. This position involves providing case management to patients. The employee is assigned to the Purchased Referred Care Division and works under general supervision of the Director of Purchased Referred Care. The incumbent provides comprehensive nursing care and/or patient services in a clinic or ambulatory care setting, and assists physicians and patients. |
| Duties: | * Provides review of referrals for specialty and hospital-based services and determine whether requests are appropriate under Purchased Referred Care criteria. * Identifies alternate resources available to patients, i.e., Medicare, Medicaid, private insurance. * Provides approval/denial to providers and patients for requested services. * Provides review of medical records documentation to support accomplished through admission certification and continued stay certification according to Interqual intensity of service and severity of illness criteria.? * Identify and refer patients to other agencies/programs such as AHCCCS, ALTC, DDD, CRS, when appropriate as well as identify and refer members for Coordination of Benefits (COB) and Third Party Liability (TPL) when appropriate. * Represents TONHC as a resource person for, and liaison between physicians and hospital/skilled nursing facility staff. * Coordinate discharge planning for all hospitalized patients by facilitating hospital discharge plans with hospital and/or skilled nursing facility staff. Attends and facilitates weekly discharge planning with TONHC case managers and other departments as needed. * Exercises independent judgement in the development and distribution of various reports required to track utilization trends of patients and providers. * Responsible for tracking of high cost cases and submission of Catastrophic Health Emergency Fund (CHEF) requests. Reports are provided to appropriate personnel and committees. ? * Performs special projects and other duties as assigned |
| Qualifications: | * Associate's Degree in Nursing * Bachelor's Degree in Nursing preferred. * Current and unrestricted license as a professional nurse in a State of the United States of America. * Two years nursing experience in a clinical setting as a registered nurse. * Current and unrestricted license as a professional nurse in a State of the United States of America. * Must have current certification in Cardio Pulmonary Resuscitation (CPR), Automated External Defibrillator (AED). * Must have a current immunization statement to include, proof of a non-reactive tuberculosis skin test within the last year, proof of immunity for hepatitis B (Documentation of immunization does not prove immunity, only a titer with a positive result is proof), within three months of hire. * Upon recommendation for hire a criminal background and National FBI check is required to determine suitability for hire. * Must possess and maintain a valid Arizona driver's license (no DUIs or major traffic citations within the last three years). * Must submit a 39-month driving record with employment application. * Must meet the Tohono O'odham Nation tribal employer's insurance requirements to receive a driver's permit to operate program vehicles. * Based on the department's needs, incumbents may be required to demonstrate fluency in both the Tohono O'odham Language and English as a condition of employment. |
| Work Type: | Permanent, Full |
| Announcement #: | 4067-(SX) |
| Who May Apply? | All Groups of Qualified Individuals |
| Get Details & Apply: | http://www.tonation-nsn.gov/wp-content/uploads/2018/03/TON-HR-Application-for-Employment.pdf |
Contact
Please use the following information to get more information about or apply for this job posting.
| Name: | Urquides, Jennifer |
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