RN Case Manager
Vesa Health & Technology is seeking Registered Nurse Case Managers for provide care at the the North Florida Sough Georgia Veterans Healthcare Systems (NFSGVHS). This is a rewarding opportunity that offers: Full benefits, reasonable patient loads, excellent pay, and generous paid time off!
Responsibility includes case management and administrative processing of Non-VA Care consults, referrals for single booking, all Choice program, VCL, Choice-First, Choice-UEXB, Choice 40 Mile, Veterans Choice Program Provider Agreements, and any other TPA or program that is implemented during the contract period of performance. One hundred percent (100%) of the time is administrative in nature and does not involve direct patient care.
* Responsible for the development, implementation, and evaluation of individualized patient care plans.
* Processing Computerized Patient Record System (CPRS) consults in a timely manner following established VA policies.
* Veteran eligibility determinations.
* Processing all types of Choice consults, which may include uploading documentation to HealthNet, the current Third Party Administrator (TPA), through their website (i.e. DOMA).
* Contacting Veterans to inform them of the Choice program and request whether they want to "opt-in" to referral for services through the program.
* Contacts are required to be made with Veterans, HealthNet staff, VA and non-VA clinicians and their office staff to successfully schedule appointments for non-VA referrals for Veterans to receive timely non-VA inpatient and outpatient medical, surgical and psychiatric care within the constraints of the Hierarchy of Purchased Care through NVCC or the Choice program.
* Process HealthNet returned authorizations and HealthNet notifications in a timely manner and respond to the TPA's requested action to ensure improved access to patient care through the Choice program.
* Facilitate and coordinate "STAT" and "URGENT" consults.
* Request medical documentation as needed.
* Attendance of monthly consult and workflow meetings.
* License: Current RN license (full and unrestricted license).
* Nursing Certification:
* Registered Nurse General with Education / License
* Two (2) or Four (4) year degree
* State Board of Nursing License within the last 24-months and Certification.
* Must be able to work for any employer in the United States.
* Technical Proficiency:
* Shall be technically proficient in the skills necessary to fulfill the governments requirements, including the ability to speak, understand, read and write English fluently.
* Must provide verifiable evidence of all educational and training experiences including any gaps in educational history.
* Must provide copies of current CEUs as required by the VAMC
* One (1) year full-time experience working as an RN in a VA or non-VA facility.
* Valid CPR/BLS card.Company Description
Vesa Health & Technology is a federal contracting company that providse all types of healthcare professionals, nation-wide, to our government clientele.