Spectrum Healthcare Resources Hiring For RN Case Manager/Care Coordinator at Fairfax, VA  Full Time

Spectrum has an opportunity for a civilian Case Manager at the Family Health Center, Fairfax, VA. We provide out-patient clinic services for enlisted and retired military personnel in association with Ft. Belvoir Community Hospital

This position provides comprehensive general and specialty case management services in support of patient care and treatment consistent with Case Management criteria in DOD/DHA/NCR/FBCH policies.

Essential Functions:

Find the most appropriate medical resources for providing optimal care and promoting the best possible outcome for the patient by providing care along a continuum, decreasing fragmentation of care across many settings, enhancing the client’s quality of life, and containing costs.
• Gather necessary information and determine the medical necessity of the services and appropriateness of certain levels of care.
• Work with DOD/DHA/NCR/FBCH and the quality division within the Clinic to provide Case Management information to clinicians and medical group leadership.
• Provide holistic patient-centered, individual and family level services for beneficiaries in support of peacetime and military readiness and contingency requirements.
• Provide the patient and family an advocate, when needed, to navigate the healthcare system to ensure the right care is appropriately provided at the right time and place.
• Develop and implement a comprehensive Case Management program for Military Health System beneficiaries in coordination with the FHCs goals and objectives.
• Facilitate in the development and integration of Case Management review policies and procedures into the medical group function.
• Serve as a liaison with higher headquarters in DOD/DHA/NCR/FBCH, professional organizations, and community health care facilities concerning the FHCs CM program.
• Conduct first level reviews for all referrals to specialty care IAW established indicators to ensure quality and appropriate, cost-effective services, for patients assigned to case management.
• Interface with TRICARE Contractor(s) and multidisciplinary personnel as needed to ensure appropriateness and completeness of referrals.
• Plan and prioritize Case Management activities to ensure identified patient needs are addressed promptly. Act as facilitator of professional and patient care activities.

Position Requirements:

• Must possess a Baccalaureate Degree in Nursing (BSN) from an accredited institution. A Master’s Degree in Nursing or related field preferred.
• Have and maintain a current and valid state license (with no limitations, stipulations, or pending adverse actions) to practice as a Registered Nurse in one of the 50 States, the District of Columbia, the Commonwealth of Puerto Rico, Guam, or the U.S. Virgin Islands.
• Two years related experience preferred.
• Obtaining CCM certification between year two and year three preferred.
• Have and maintain current certification in Basic Cardiac Life Support (BLS).
• Shall be able to read, write, and speak English well enough to effectively communicate with patients and other staff members.
• Have knowledge of computer operations and proficiency in the use of basic word processing, data entry, and automated records.

Spectrum Healthcare Resources is an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.

EOE/AA/Disability/Vet