This position is located in the Purchased Referred Care (PRC) section at Gallup Indian Medical Center in Gallup, NM. The primary responsibilities involve providing clinical case management support to the Purchased/Referred Care Program, coordinating healthcare services between inpatient, outpatient care teams, external entities. Providing direct case management services in collaboration with other outpatient case management and clinical practice managers.
To qualify for this position, your resume must state sufficient experience and/or education, to perform the duties of the specific position for which you are applying. Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religious; spiritual; community; social). You will receive credit for all qualifying experience, including volunteer and part time experience. You must clearly identify the duties and responsibilities in each position held and the total number of hours per week. BASIC REQUIREMENT(S): Education: A graduate or higher level degree, bachelor's degree, associate degree, or diploma from an accredited professional nursing educational program is required. This education must have been accredited by the Commission on Collegiate Nursing Education, Council on Accreditation of Nurse Anesthesia Educational Program, Accreditation Commission for Midwifery Education, or an accrediting body recognized by the U.S. Department of Education at the time the degree was obtained. Degree from Foreign Nursing School: Official certification from the Commission on Graduates of Foreign Nursing Schools is required for individuals who graduated from foreign nursing schools. Licensure: For all grade levels and positions, applicants must have passed the National Council Licensure Examination. In addition, they must possess a current, active, full, and unrestricted license or registration as a professional nurse from a State, the District of Columbia, the Commonwealth of Puerto Rico, or a territory of the United States. Basic Requirements for the GS-11 (or equivalent) Grade Level In addition to the above requirements, applicants must meet one of the following requirements: Successful completion of a PhD or equivalent doctoral degree from a professional nursing educational program or related medical science field; or At least one full year of professional nursing experience (equivalent to the GS-9 grade level) and possession of a diploma, associate degree, bachelor's degree, or master's degree from a professional nursing educational program. Your resume must demonstrate specialized experience equivalent to at least the next lower grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: Serve as an authority in care coordination and case management matters. Operation of a health care financing, purchased and referred care programs including Coordination of Benefits, Medicare and Medicaid program benefits, accessing private insurance benefits, and health care contracts and agreements, providing patient care needs in collaboration with other case management and clinical practice managers. Time In Grade Federal employees in the competitive service are also subject to the Time-In-Grade Requirements: Merit Promotion (status) candidates must have completed one year of service at the next lower grade level. Time-In-Grade provisions do not apply under the Excepted Service Examining Plan (ESEP). You must meet all qualification requirements within 30 days of the closing date of the announcement.
This position is being announced concurrently under Direct Hire Authority procedures. Please review vacancy announcement number IHS-25-GA-12737360-DHA; for eligibility requirements. Total Compensation Package - Check out IHS's outstanding total compensation package for this job: Registered Nurse Total Compensation | Pay (ihs.gov) Serves as a clinical liaison and resource for the staff for clarifying provider referrals/orders; assists with the care coordination and care management of primarily uninsured and some insured patients/referrals. Co-manages patient care needs with outside agency case managers and social workers of hospitalized patients that transition levels of care to ensure the patient receives the most cost-effective, appropriate and timely treatment. Promotes the coordination, collaboration and continuity of care by direct services as a case manager. Workload includes actual case management consults and work on complex referrals and with patients with multiple barriers to care. Develops a care and service delivery plan with the patient/family and interdisciplinary team (including service unit's and other non-IHS providers as appropriate) based on the needs identified and available provider and financial resources. Prepares patients, families, and providers for termination (discharge) from case management when services are no longer required. Arranges for any ongoing support/direct care services that the patient will need in coordination with service unit case managers and discharge planners, to include tribal entities when appropriate (i.e., tribal programs).