FIND_THE_RIGHTJOB.
Muskogee, United States
Provides nursing care according to Cherokee Nation's policies, standing orders, and as ordered by the physician or mid-level in the ambulatory setting.
Specific to Cancer Care Case Management:
Reviews patient medical records to determine eligibility for grant and other programs according to applicable rules, regulations, and guidelines. Plans, develops, and implements assurance monitors for the designed grant or other program. Ensures validity, quality, and timeliness in grant and other program reporting submissions as required. Tracks and follows all patients receiving abnormal screening result(s) and in collaboration with the health care provider, assesses needs, issues, resources, and goals.
Specific to Purchased and Referred Care (PRC) Case Management:
Reviews patient medical records and PRC referrals to determine eligibility for program(s) according to applicable rules, regulations, and guidelines. Plans, develops, and implements quality assurance monitors for the PRC program as assigned. Makes inquiries to obtain alternate resources for services recommended for patients by provider. Consults with staff and multidisciplinary health care providers as necessary to facilitate appropriate decision-making in referral services. Screens authorizations and reports those exhibiting potential catastrophic cost to the appropriate party(ies). Enters orders as received by the Orders Management Team.
SUPERVISORY RESPONSIBILITIES
This job has no supervisory responsibilities.
Qualifications:EDUCATION REQUIREMENT
Graduate of an accredited practical nurse or vocational nursing program.
EXPERIENCE REQUIREMENT
None.
COMPUTER SKILLS
An individual should have knowledge of Database software; Spreadsheet software and Word Processing software.
CERTIFICATES, LICENSES, REGISTRATIONS
Must possess a license as a Licensed Practical Nurse (LPN) from the Oklahoma Board of Nursing (OBN) or possess a multistate LPN license accepted by the OBN, no substitutions. Must be certified in Basic Life Support (BLS) and maintain throughout employment. Can be obtained during orientation. Must be certified in Advanced Cardiac Life Support (ACLS) and maintain throughout employment. If not certified, ACLS certification must be obtained within ninety (90) days of hire. A driver's license may be required to work in some departments. If so, the applicant/employee must possess a valid driver's license with a driving history verified through a motor vehicle report that meets requirements for Cherokee Nation underwriting rating. Must meet and maintain pre-employment and periodic background investigation and adjudication for child care.
OTHER QUALIFICATIONS
Employee must not be and will not be under sanction by the United States Department of Health and Human Services Office of the Inspector General (OIG) or by the General Services Administration (GSA) or listed on the OIG's Cumulative Sanction Report, or the GSA's List of Excluded Providers, or listed on the OIG's List of Excluded Individuals/Entities (LEIE). Educated on and compliant with HIPAA regulations; maintains strict confidentiality of client information.
PHYSICAL DEMANDS
While performing the duties of this job, the employee is frequently required to stand; walk; sit; use hands to finger, handle, or feel; reach with hands and arms and talk or hear. The employee is occasionally required to climb or balance; stoop, kneel, crouch, or crawl and taste or smell. The employee must occasionally lift and/or move up to 50 pounds.
WORK ENVIRONMENT
While performing the duties of this job, the employee is occasionally exposed to fumes or airborne particles and toxic or caustic chemicals. The noise level in the work environment is usually moderate.
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