RN REFERRAL MANAGEMENT COORDINATOR

Location
Bethesda, Maryland
Salary
95k per year with benefits
Posted
Sep 05, 2017
Closes
Oct 05, 2017
Ref
WALT REED RN
Specialty
Case Management
Contract Type
Contract
Hours
Full Time

PROFESSIONAL QUALIFICATIONS / RESPONSIBILITIES.  All Contractor HCP’s shall meet the qualifications for that specialty and perform essentially the same functions, within the scope of acceptable for their technical professional discipline and standard, as those required by Army or government service technical professionals of similar experience and in similar duty assignments.  Contractor HCP practices/productivity will be compared to that of other Contractor HCP assigned to the same medical center.

 

 

 

REQUIRED:     U.S. CITIZENSHIP, VALID STATE RN LICENSE

 

 

 

 

 

  • The Registered Nurses shall possess and maintain current License for Registered  Nurse at least one state or territory in the United States.  Posses a valid, current license (with no limitations, stipulations or pending adverse actions) to practice Family Medicine in at least one state or territory in the United States.  All licenses must be unencumbered and remain in effect during contract employment.  

 

 

  • Contract providers shall be of quality meeting or exceeding current recognized national standards as established by the Joint Commission on Accreditation of Healthcare and the standards of the American Army, or Department of Defense treatment Facility Association.   In addition to the qualifications given here the Family Registered Nurse Registered Nurse shall have sufficient experience to perform the tasks and procedures given in 1.6.

 

 

  • The Registered Nurses must be a graduate from an academic program, within nursing specialty of field of study (Family Registered Nurse Registered Nurse) that is accredited by a regional or national nursing accrediting agency recognized by the US Department of Education.  Acceptable Masters Program includes Masters of Nursing (MSN) or Masters of Science w/nursing focus (MS).

 

 

  • Shall have a minimum of at least 5 years experience as Registered Nurses (e.g. emergency room and orthopedics) and at least 2 years of which in Family Medicine.  

 

 

The Contract Registered Nurses performing under this Contract shall be able to read, write, speak and understand English well enough to effectively communicate with all patients and other health care providers.

 

 

 

  • Shall have and maintain current certification in Basic Cardiac Life support (BCLS), Certificated through the American Heart Association/American Red Cross.  Certifications must be maintained and renewed at no additional cost to the Government. 

 

 

  • Shall have the ability to function independently and manage a busy caseload of two to three patients simultaneously 

 

 

  • Shall have transcript verifying Licensed Registered Nurses education provided with resume 

 

 

  • Shall Demonstrate ability in the areas of interpersonal relations, problem solving, and conflict resolution.

 

 

  • The Contractor shall report to work rested and fully physically and mentally capable of performing the duties required under this contract.

 

 

  • Any Contractor HCP personnel found to be unacceptable in administering skill required by the contract shall be immediately released from duty by the Contracting Officer’s Representative (COR).  The COR will immediately notify the Contracting Officer.

 

 

SPECEFIC DUTIES/TASK THE CONTRACTOR HCP SHALL PERFORM BUT NOT LIMITED TO:

 

 

 

The Registered Nurses shall perform the following procedures, as required and in strict compliance with standing orders and protocols set forth by the MTF to include, but will not necessarily be limited to the following:

 

 

 

  • Shall not introduce new procedures of services without prior approval of the Department

Chief, or counterpart.  In disagreements or deviations from established or new protocols, the Department Chief of counterpart, will be the deciding authority.  The Department Chief or counterpart will define the scope of practice and establish therapeutic practices

 

 

 

  • Shall plan and initiate proper treatment with in the FNP’s defined privileges and the scope of practice of the facility.

 

 

  • Shall identify and report those situations and individual cases which have public health significance and carry out effective control measures.

 

 

  • Shall clearly communicate to other  health personnel either orally or in writing the findings, diagnosis, and planned treatment regimen.

 

 

  • Shall stabilize and manage a patient in a medical or surgical emergency and/or transfer to physician care.

 

 

  • Shall determine appropriate means of evacuation of emergency patients, prepare patients for evacuation, and arrange for evacuation support

 

 

  • Shall maintain addition skills acquired through further training and experience may be reflected through Continue Education Units (CEU).

 

 

  • Will be employed under the supervision of a government provider physician who remains accountable for the FNP’s diagnosis and therapy.

 

 

  • Shall make use of all available equipment, supplies and services (specialty consultations, ancillary and administrative services), for the optimal care of the patients. 

 

 

The contract Registered Nurses performing services under this contract shall have sufficient skills to perform tasks that may include, but are not necessarily limited to the following:

 

 

 

Consult as appropriate (with primary care managers and with other specialists) on Family

 

Practice, Allergy, and Infectious Disease Issues Provide medical advice over the telephone

 

Complete all required paperwork

 

Obtain an adequate history, physical, assessment and develop a treatment plan in a timely and appropriate manner on each patient Utilize paraprofessionals as appropriate

 

Respond to and provide initial management of cardiopulmonary arrests and arrange back up from

 

Emergency Medical Services (EMS)) as appropriate

 

Make preliminary interpretation of electrocardiograms

 

Perform documentation and patient care IAW JC guidelines

 

 

 

The Contractor HCP shall assume additional administrative or clinical duties as requested or needed to ensure sustainment of normal clinic operations and ensure compliance with JC standards, to include, but not limited to, managing daily schedules, reviewing and dispositioning consults, monitoring appointment utilization and patient access to care, conducting mandatory clinical training, monitoring clinic supplies and equipment, ensuring enforcement of clinic SOPs and standards, conducting monthly peer review and conducting staff meetings.

 

 

 

Quality Improvement shall include the following responsibilities:

 

 

 

  • Assist in quality improvement data collection and review
  • Help with problem solving regarding quality improvement issues
  • Participate in multidisciplinary functional groups and process action teams as needed
  • Uphold established patient care and practice standards
  • Participate in ongoing review of clinic policies and procedures and make appropriate revisions    as required     
  • Review and submit reports as required
  • May be assigned to other clinics in the MCAHC footprint on a temporary basis as needed or for additional on the job training
  • Participate in all mandatory training 

 

 

Complete all required paperwork

 

Utilize paraprofessionals as appropriate

 

Perform documentation and patient care IAW JC guidelines

 

 

 

The Contractor HCP shall assume additional administrative or clinical duties as requested or needed to ensure sustainment of normal clinic operations and ensure compliance with JC standards, to include, but not limited to, managing daily schedules, reviewing and dispositioning consults, monitoring appointment utilization and patient access to care, conducting mandatory clinical training, monitoring clinic supplies and equipment, ensuring enforcement of clinic SOPs and standards.

 

 

 

Quality Improvement shall include the following responsibilities:

 

  • Uphold established patient care and practice standards
  • Review and submit reports as required
  • May be assigned to other clinics in the NCR- MD HQ footprint on a temporary basis as needed or for additional on the job training      -     Participate in all mandatory training

 

 

•     Utilizes the Composite Health Care System (CHCS) and AHLTA (electronic medical record). The Government is responsible for training the contractor in the use of CHCS. Also uses ADS and other automated data systems instituted by the US Army.

 

 

 

The contract Registered Nurse performing services under this contract shall have sufficient skills to perform tasks that may include, but are not necessarily limited to the following:

 

 

 

Complete all required paperwork

 

Utilize paraprofessionals as appropriate

 

Perform documentation and patient care IAW JC guidelines

 

 

 

The Contractor HCP shall assume additional administrative or clinical duties as requested or needed to ensure sustainment of normal clinic operations and ensure compliance with JC standards, to include, but not limited to, managing daily schedules, reviewing and dispositioning consults, monitoring appointment utilization and patient access to care, conducting mandatory clinical training, monitoring clinic supplies and equipment, ensuring enforcement of clinic SOPs and standards.

 

 

 

Quality Improvement shall include the following responsibilities:

 

 

 

  • Uphold established patient care and practice standards
  • Review and submit reports as required
  • May be assigned to other clinics in the NCR- MD HQ footprint on a temporary basis as   needed or for additional on the job training     -     Participate in all mandatory training 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2) Referral Management Coordinator  

 

 

 

PROFESSIONAL QUALIFICATIONS / RESPONSIBILITIES.  All Contractor HCP’s shall meet the qualifications for that specialty and perform essentially the same functions, within the scope of acceptable for their technical professional discipline and standard, as those required by Army or government service technical professionals of similar experience and in similar duty assignments.  Contractor HCP practices/productivity will be compared to that of other Contractor HCP assigned to the same medical center.

 

       

 

  • Implement improved ways to review and develop processes to improve the Referral Management process.
  • Review all details of referral for suitability, administrative and clinical completeness, and required tests and pre-work for disposition per IRMAC guidelines
  • Verify patients are registered in CHCS and DEERS information.  Update demographic information as needed.
  • Provide patient with basic information regarding their referral and health treatment options are as related to their eligibility and beneficiary status.
  • Appoint PCM and specialty care referrals appointments to MTF or Direct Care System or forward referrals via fax transmission to the MCSC for network appointing.
  • Inform patients that civilian provider encounter reports are returned to IRMAC
  • Monitor trends of clinics requiring IRMAC guideline education
  • Provide education for template managers
  • Follow-up with MTF provider who did not complete referral results within required timeline.
  • Review of monthly reports with data analysts 
  • Perform administrative duties that support referral and appointment management applicable information and communication management and other duties in support of MHS beneficiaries.  These duties performed within established standard policies and business rules and under the supervision of either Referral Management or Appointing supervisors
  • Receive patient calls determining appointment needs according to managed care rules
  • Referrals reviewed as required
  • Verify patients are registered as required
  • PCM/Specialty referral appointments scheduled as needed
  • Enter referrals, review referrals, and close referrals as required.  
  • Maintain communication with specialty clinics on proper templates and scheduling procedures in CHCS
  • Maintain effective communication with appropriate staff and work closely with technical staff to ensure efficient operation.
  • Constantly meet established productivity, schedule adherence, and quality standards while maintaining good attendance.
  • On occasion, is able to take on Team Lead responsibilities as requested by the Referral Management Team Lead.  

 

 

 

 

 

 

 

 

This position requires: strong customer service skills, proficiency in using Microsoft  Office, CHCS, AHLTA, CCS/CareRadius, and RMS as well as the ability to work self-directed, demonstrated organizational skills, sound understanding of TRICARE enrollment and DEERS, and ability to work well with all levels of internal management and staff, as well as outside clients and vendors. 

 

 

 

The successful incumbent will possess:

 

 

 

  1. A high school diploma or general education development equivalency (GED) and any combination of academic education, professional training or work experience, which demonstrates the ability to perform the duties of the position.

 

 

  1. Minimum of six months experience working in a medical environment, customer or member service Call Center, preferably with emphasis on appointment scheduling.

 

 

  1. Experience using Composite Health Care System (CHCS) preferred.

 

 

  1. Thorough knowledge of the Military Health Care System, TRICARE, medical terminology, release of medical information, and medical and legal ethics. 

 

 

  1. Accurate data entry and attention to detail.

 

 

  1. Standard office administrative practices and procedures, including the use of standard office equipment to accomplish clerical, statistical and data entry tasks in support of the administrative work of the office.

 

 

  1. Computer skills, i.e., Microsoft Word, Excel, PowerPoint and Access.

 

 

  1. Superior customer service and organizational skills

 

 

  1. Strong verbal and written communication skills and sound judgment

 

 

  1. Ability to manage and utilize multiple complex microcomputer systems for appointment scheduling

 

 

  1. Highly organized, detail-oriented with strong organizational skills and ability to work effectively and independently with a positive attitude.

 

 

  1. Ability to multi-task.

 

 

More jobs like this