Nurse Case Manager

Navajo Preference Employment Act

In accordance with Navajo Nation and federal law, TCRHCC has implemented an affirmative action plan pursuant to the Navajo Preference in Employment Act. Pursuant to this plan and corresponding TCRHCC policy, applicants who meet the necessary qualifications for this position and (1) are enrolled members of the Navajo Nation, Hopi Tribe, or San Juan Southern Paiute Tribe will be given preference in hiring and employment for this position, (2) are legally married to enrolled members of the Navajo Nation, Hopi Tribe, or San Juan Southern Paiute Tribe and meet residency requirements will be given secondary preference, and (3) are enrolled members of other federally‑recognized American Indian Tribes will be given tertiary preference.

Incumbent serves as an Outpatient/Inpatient Nurse Case Manager for TCRHCC and at Sacred Peaks Healthcare Center (SPHC) as the supportive contact for specified groups of identified high‑risk patients; will specifically focus on specialty clinics that need specific case‑management attention. The case manager meets essential health and social needs for patients while ensuring quality, cost‑effective healthcare. The case manager facilitates care transitions from admission through discharge ensuring continuity of care, alignment of services, and post‑hospital referrals to continuing care agencies.

Also serves as a resource for nursing, physicians and ancillary departments on transitional and regulatory issues. The case manager will experience working with culturally diverse patient populations having multiple barriers to self‑sufficiency such as illiteracy, welfare dependency, domestic violence, substance abuse, and mental health issues. The Nurse Case Manager will be responsible for assessment, service planning, resource acquisition, monitoring progress and initiating the responding to emerging client needs.

Collaborates with an interdisciplinary team to assess care plans, monitor progress, and make recommendations to ensure safe and efficient hospitalizations. Responsible for evaluating patients in the ED for medical necessity and care coordination needs. Assesses potential admissions and works with advanced practice clinicians/physicians to determine appropriate admission status. Proposes and implements outpatient plans for safe discharge from the ED with physician approval.

Coordinates care for patients with abuse, chronic pain, and frequent utilization issues. Interacts with patients or customers of all ages, from newborn to geriatric. As part of this role, they will also interact with individuals who have mental health issues to help them access and navigate the resources they need to improve their well‑being.

• Associate’s or Bachelor’s Degree in Nursing

• A valid, current, full and unrestricted Professional Nursing License to practice nursing in any state of the United States of America, The Commonwealth of Puerto Rico, or a territory of the United States
• Must have and maintain current Basic Life Support (BLS) certification by the American Heart Association throughout employment

• Three (3) years of clinical nursing experience, including (1) year in an Outpatient/Inpatient setting
• Demonstrated knowledge of the case management, contract health, and utilization review processes

• A record of satisfactory performance in all prior and current employment as evidenced by positive employment references from previous and current employers
• Positive working relationships with others
• High ethical standards and no history of complaints
• Reliable and dependable; reports to work as scheduled without excessive absences
• Effective verbal & written communication skills
• Team management focus promoting a positive and proactive approach to problem resolution
• Completing and surpassing satisfactory scores on all job interviews, demonstrating to the satisfaction of the interviewees and TCRHCC that the applicant can perform the essential functions of the job
• Successful completion of and positive results from all background and reference checks, including positive employment…