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Full Time Case Manager Nurse Job Tucson, AZ

Full Time
Tucson, AZ
alarm 2 months ago
Posted by Avosys
Employer Avosys Technologies

Job Description


  • Provide patient-centered case management and discharge/disposition planning in inpatient and ambulatory care settings, with early identification and interventions focused on outcomes.
  • Apply the nursing process to systems or processes at the unit, team, and work group level to improve care. As a member of the team, participate fully in the development, implementation and evaluation of interdisciplinary treatment plans which include all provisions of case management services.
  • Participate in the development, implementation and maintenance of a systematic assessment of clinical, administrative and research practices in support of Utilization Management, Risk Management, Case Management and Performance Improvement processes.
  • Ensure initial and ongoing assessments of patients to identify needs, issues, resources and care goals arc provided, in a timely manner. Ensure the patient is screened for social service needs, home care, and other community care needs, and that referrals are coordinated and made as necessary and appropriate by the responsible discipline.
  • Address patient health education needs through education and/or teaching, as per identified needs, is provided to patients and/or significant other by responsible discipline.
  • Analyze the clinical contents of medical records and associated documents, in terms of the quality and
    appropriateness of clinical care issues, such as adherence to, or deviation from accepted practice guidelines, standards and/or procedures. Report findings accordingly.
  • Apply Continuous Quality Improvement (CQI) tools in data collection and identify barriers to the achievement of quality improvement in interdisciplinary treatment teams and/or clinical programs. Seek assistance from other Case Managers, as needed.
  • Proactive in case finding and identify patients who are potential candidates for case manager enrollment or in need of care coordination through discharge/disposition planning to include, but not limited to:
    • Multiple complex healthcare needs, such as but not limited to: patients requiring home IV
      therapy/chemotherapy; investigational protocol patients; injury-prone; post-deployment service members, etc.
    • Catastrophic, severe illness or traumatic injuries that may result in death or major permanent loss of function (sensory, motor, physiologic, intellectual), such as but not limited to: traumatic injuries; Acquired Immune Deficiency Syndrome (AIDS); neoplasms; neonates admitted to Intensive Care Units; major burns, organ transplants; bone marrow transplants, etc.
    • Chronic, major diseases and conditions that may result in permanent lessening of quality of life, health, safety, productivity, functioning, permanent disability, and, or increased-risk for diminished independence, such as, but not limited to: poorly controlled chronic disease; depression; dual medical and psychiatric diagnoses; dual psychiatric and substance abuse diagnoses, etc.
    • Follow-up care and appointments, and services determined by the physician such as types of medical equipment needed for in home and post-hospitalization use or rehabilitation/extended care placement, and other care arrangements, as necessary.
  • Encourage and accept case management referrals from multiple sources, such as healthcare team members, line/employers, and the purchased care system.
  • Monitor care delivery to the patient across the care continuum (sub-acute, long-term and home healthcare) and document assessments of patient progress in reaching healthcare outcome goals.
  • Collaborate with direct and purchased care systems to ensure a smooth transition for patients from one level of care or care setting to another, such as rehabilitation, residential or other care institution.
    • For example, in the case of an Active Duty Service Member (ADSM) with severe head trauma, the Registered Nurse (RN) or Master's Social Worker (MSW) shall collaborate with the Veterans Administration (VA), and Military Medical Support Office (MMSO) to identify best options for the ADSM's access to transportation, rehabilitative care, or other extended long-term healthcare programs, and coordinate with the Global Patient Movement Requirements Center (GPMRC) for aeromedical evacuation, as needed.
    • Ensure coordination of care delivery processes to enhance patient's health and wellness, safety, productivity, and quality of life, to include alternate care settings and the home environment.
    • Develop and use appropriate military and community resources. Maintain personal contacts in this position that are, but not limited to: active duty service members, veterans, and their families; other facility clinical and administrative staff; staff at Military Treatment Facility (MTF), TRICARE, National Guard and Reserve units; community agencies; students in training; and representatives of local, state, and Federal institutions.
    • Serve as an advocate for service members and/or veterans and their families, helping them access needed services at military facilities, at VA facilities, and in the community that leads to adherence to treatment plan and improved healthcare outcomes.
    • Assist military service members and/or veterans and their families with advance directives, guardianships, and applications for home care and extended care services.
    • Participate in the orientation, training/teaching of other staff. May serve on committees, work groups, and task forces at the MTF, or as a representative of the MTF for other agency taskings.
    • Conduct and/or participate in research and/or program evaluation as appropriate. This may include, but is not limited to, statistical analysis of Case Management data to identify variances, patterns or trends from established practice guidelines and/or standards.
    • Participate in interdisciplinary team meetings, appropriate MTF meetings, and Case Management/Social Work meetings. Share knowledge and experiences gained from own clinical practice and education relevant to nursing and case management.
    • In coordination with Patient Centered Medical Home (PCMH), team base approach to delivering primary care to patients at Defense Health Agency (DHA) facilities in accordance with Air Force Medical Service (AFMS), assist clinical programs and treatment teams in preparation for operations accreditation and other internal or external reviews. Monitor follow-up recommendations.
    • Maintain a level of productivity and quality consistent with facility and Social Work standards and the complexity of the assignment and in accordance with established principles, standards of practice, and ethical guidelines of their respective professional national organizations, and the American Accreditation Healthcare Commission/Utilization Review Accreditation Commission (URAC) Case Management Standards; the Case Management Society of America (CMSA); Joint Commission of Accreditation and Healthcare Organizations (JCAHO); The Accreditation Association for Ambulatory Healthcare (AAAHC) and applicable DoD and Service
      specific guidance and policies. Comply with the Equal Employment Opportunity (EEO) Program and safety policies and procedures.


  • Master's Degree in Nursing or a related field preferred, with a Baccalaureate/Associate degree in Nursing or related field from a National League for Nursing (NLN) accredited program or regionally accredited college or university.
  • At least 5 years of successful nursing practice. 2 years experience in Discharge Planning or Case Management preferred. Certification in Case Management preferred.
  • Mastery of theories, principles, and methodologies underlying psychosocial practice.
  • Knowledge and understanding of developmental growth; dynamics of human behavior, family ,and other social systems; and the impact of illness and disability on social functioning.
  • Knowledge of accreditation standards, privacy and confidentiality requirements, such as Joint Commission on and Accreditation Association for Ambulatory Health Care (AAAHC).
  • Working knowledge of Department of Defense (DoD), Federal, State, non-profit healthcare systems and organizations, to include DoD Tri-Service Military Healthcare Systems, TRICARE purchased care system, Medicare, Medicaid, Veterans Administration (VA), Public Health Department, and Regional and local support services.
  • Working Knowledge of Microsoft Office programs, Outlook and Internet familiarity is required.
  • Working knowledge of operations of various microcomputer equipment, and the ability to input, retrieve and format documentation. Ongoing training in the Composite Health Care System (CHCS) and other computer information systems is necessary.
  • Ability to type a minimum of 40 words per minute.
  • The work is primarily sedentary. However, there may be some physical demands. Requirements include prolonged walking, standing, sitting or bending.

License - Certifications

  • Current, active, full, and unrestricted License to practice Nursing. Nurse applicants must be a current U.S. licensed Registered Nurse. License cannot be under investigation nor have any adverse action pending from a Nursing State Board or national licensing/certification agency.
  • BLS Certification

Other Information


US Citizenship Required:Yes

Background Check:Required

Current Clearance Level Required:None



Equal Opportunity Employer/Veterans/Disabled

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, gender identity, national origin, or protected veteran status and will not be discriminated against on the basis of disability. If you are an individual with a disability and require a reasonable accommodation to complete any part of the application process, or are limited in the ability or unable to access or use this on-lineapplication process and need an alternative method for applying, you may contact (210) 888-0775 orJobs@Avosys.comfor assistance.