Lead RN Case Manager

About the role

This Position is Contingent on Upon Contract Award

Position Overview

The Position supports the Non-Clinical Case Management Services contract as a Lead RN Case Manager. This position provides non-clinical medical case management services to the Vermont Army National Guard (VTARNG), coordinating care for service members to promote medical readiness and deployability.

Responsibilities

• Lead a team of RN Case Managers and Medical Records Technicians, providing supervisory oversight, workload management, and quality assurance across all case management activities.
• Establish and maintain eCase profiles for all service members referred by a provider; ensure profiles are created no later than one (1) workday after provider referral.
• Carefully coordinate all aspects of non-clinical case management for VTARNG service members with complex or at-risk medical needs, facilitating care across military and civilian medical facilities.
• Prepare and submit monthly Case Status Reports and MRC3/DRC3 Profile Management Reports no later than the 7th calendar day of the following month.
• Provide liaison services and coordinate with the lead medical provider on difficult case files on a bi-weekly basis.
• Facilitate case management initiatives and deployment operations; ensure medical records are ready for transfer to unit representatives 72 hours prior to mobilization.
• Conduct monthly case reviews with VTARNG Commands and Health Services; prepare cases and attend MEB/PEB boards.
• Support scheduled Periodic Health Assessment (PHA) and Soldier Readiness Check/Soldier Readiness Process (SRC/SRP) events, including weekend readiness events as required.
• Review MEDCOM policy and SOPs for compliance; initiate corrective actions using PIPs and SOPs as needed.
• Verify accuracy of MEDPROS data prior to Medical Readiness Events.
• Ensure all medical charting, documentation, and record uploads into MEDCHART/eCase are completed within three (3) business days of encounter or receipt of medical information.
• Coordinate Soldier treatment plans with appropriate military and civilian medical facilities; communicate with Soldiers’ units regarding scheduled appointments and attendance.
• Maintain HIPAA standards, protect PII/PHI, and ensure all personnel complete required annual HIPAA and Privacy Act training.
• Develop and maintain the Quality Control Plan (QCP) and OPSEC SOP/Plan; ensure team compliance with AT Level 1, iWATCH, OPSEC, and Information Assurance training requirements. Serve as the Lead Non-Clinical Nurse Case Manager, providing liaison services and coordinating with the lead medical provider on the most complex case files on a bi-weekly basis.
• Establish and maintain eCase profiles for Soldiers referred by a provider within one workday of referral.
• Schedule, prepare for, and attend Periodic Health Assessments (PHA) and Soldier Readiness Checks/Soldier Readiness Processes (SRC/SRP) events.
• Provide a monthly report of all cases and their status (condition identification through medical readiness or separation), due no later than the 7th calendar day of the following month.
• Complete all medical and administrative charting in eCase, DENCLASS, MEDPROS, eProfile, MHA/PHA, MEDCHART, AVS, AHLTA, MODS, and MWDE within three business days of receipt of information.
• Prepare Soldier records for and attend MEB/PEB boards; review and reconcile hardcopy and electronic case information for file completeness at least one workday prior to scheduled board.
• Facilitate case management initiatives and deployment operations within 15 days of receipt; coordinate medical records transfer to mobilization sites 72 hours prior to Soldier mobilization.
• Conduct monthly case reviews with representatives of VTARNG Commands and Health Services with support from the Deputy State Surgeon (DSS).
• Verify accuracy of MEDPROS data before Medical Readiness Events to enable early identification of non-deployable Soldiers.
• Communicate with delegated government personnel to track compliance versus noncompliance during monthly case reviews.
• Coordinate Soldier treatment plans with appropriate medical facilities; request profile exams, evaluations, and audiology exams within three business days of initial examination.
• Educate Soldiers on resources available to improve medical and dental readiness.
• Ensure all medical documentation received is scanned, filed, and placed in MEDCHART and hard copy records; log and forward documents to Records Custodian within 3 business days.
• Maintain Soldier medical records in accordance with AR 40-66; upload medical documents to Health Readiness Record (HRR) and stamp all documents upon upload.
• Maintain HIPAA standards and guidelines and protect all Personally Identifiable Information (PII).
• Develop and maintain an effective Quality Control Plan (QCP) and OPSEC SOP/Plan.
• Provide case management support to mobilizations, including MHS GENESIS records review, SRP Level 1 and Level 2 attendance, and support at the Mobilization Station (travel may be required).

Qualifications

• Active, unrestricted Registered Nurse (RN) license in good standing in the state of Vermont; a multi-state Nurse Licensure Compact (NLC) license with Vermont practice privileges is acceptable.
• Minimum of two (2) years of relevant clinical or case management experience.
• Minimum of two (2) years of supervisory or team lead experience in a clinical or case management setting (in addition to the base clinical experience requirement; minimum 4 years total professional nursing experience).
• Must be a U.S. Citizen and able to obtain a Common Access Card (CAC) via a favorably adjudicated Tier 1 (NACI) background investigation.
• Completion of an accredited nursing program.
• Ability to support weekend Soldier Readiness events and occasional travel (Fort Bliss, TX for mobilization events).

Preferred Skills/Experience

• Bachelor of Science in Nursing (BSN) or higher.
• Certified Case Manager (CCM) credential or equivalent certification.
• Documented, recent experience (within the past 5 years) directly utilizing Army medical readiness systems such as MEDCHART, MHS GENESIS, and/or MEDPROS.
• Previous experience within a Military Health System (MHS) environment or supporting military medical readiness programs.