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Lead Case Manager

Education Requirements: ​

  • A minimum of a Registered Nurse (RN), Direct Service Social Worker as Non-clinical Case Managers or a person with a bachelor’s degree in a Health related field with three years’ experience as a Case Manager, to provide IMR support to the New York Army National Guard.

General Skill Set Required:

  • Strong organizational skills –ability to prioritize tasks, keeping a timeline on projects, maintain focus on important projects and delegate as needed.
  • Strong communication skills, both written and oral
  • Basic knowledge of standard office procedures and the ability to interpret general instruction
  • Knowledge and experience needed to use Microsoft Office Suite including but not limited to Excel, Word, PowerPoint and Outlook

Job Responsibilities: 

  • Responsible for tracking medical status of ALL assigned Soldiers.
  • Request profile exams/evaluations and audiology exams at physical exam center.
  • Coordinate Soldier treatment plans with appropriate medical facilities.
  • Maintain automated referrals indicated in MEDCHART.
  • Submit case processing, medical documentation, and profile concerns to military/contacted provider.
  • Attend MRE’s events as determined by the needs of the state and the individual units.
  • Ensure Soldiers referred by a provider are followed by the case management team.
  • Manage Soldier’s care from the identification of the condition to when the Soldier is either:
    • Considered medically ready.
    • Administratively separated from the military.
  • Ensure all medical documentation received from the Soldier and/or their medical team is received and placed in appropriated electronic record, as well as the Soldier’s hard copy record.  54.10 Maintain Soldier medical records in accordance with Army Regulation (AR) 40-66, Medical Record Administration and Healthcare Documentation.
  • Obtain release of information from Soldier.5.12 Educate Soldiers on resources available to improve medical and dental readiness.
  • Maintain Health Insurance Portability and Accountability Act of 1996 (HIPAA) standards and guidelines.
  • Review and track health assessment lab results and contact SM and educate on lifestyle modi5.4.13 Upload medical documents of case managed Soldiers into Health Readiness Record (HRR).
  • Stamp all medical documents for verification after uploading.
  • Index uploaded medical documents.
  • Update MODS as required on the following:  immunizations, designation of pregnancy, eye exams, and medical warning tags. 
  • Provide all medical documents received for case management to NYARNG Medical Command, (Records Custodian), for filing, using a document evidencing chain (hand-off) of custody from the contractor to the government.
  • Track medical appointments by communication with unit to ensure Soldier attendance and submission of follow up documentation.
  • Log in eCase any contact with SM (email, voice call, or personal interview).
  • Communicate with delegated government personnel to track compliance versus noncompliance.
  • Run MEDPROS report Post MRE event.
  • Monitor MEDPROS to ensure all scheduled services are completed/updated and current medical status is reflected.
  • Report Medical Readiness to the Commander or his/her designated representative.
  • Ensure Soldiers with P3 or P4 profiles, (A profile containing one or more numerical designators of “3” signifies that the individual has one or more medical conditions or physical defects that may require significant limitations. The individual should receive assignments commensurate with his or her physical capability for military duty.(4) A profile serial containing one or more numerical designators of “4” indicates that the individual has one or more medical conditions or physical defects of such severity that performance of military duty must be drastically limited) are all case managed in the eCase module.
  • Prepare cases for and participate in monthly review of all open case files with Lead Case Manager/DSS.fications.
  • Works directly with the DSS on the most difficult case files.
  • Responsible for overall quality assurance and timeliness of delivery for all work performed.
  • Responsible for facilitating case management initiatives, deployment operations including coordinating with  Medical Records to ensure timely and accurate processing of medical records to and from mobilization site.
  • Knowledgeable and assists with all aspects of Case Management operations and procedures.
  • Current on all guidelines and regulations impacting Case Management and or Medical Records.
  • Responsible for keeping projects on track and possessing the ability to foresee the entire project as a whole at all times.
  • Resolving problems; reviewing MEDCOM policy and SOP to ensure compliance to current standards. Initiating corrective actions by using the Performance Improvement Plan, SOP’s, and internal guidelines or procedures. 
  • Facilitation of projects and initiatives as they are received from the DSS/COR
  • Coordination includes assisting with and attending the Medical Readiness Events (MRE), (both for mobilization/deployment and routine readiness).
  • Assist Soldier’s with their Medical Readiness in conjunction with the Deputy State Surgeon (DSS).
  • Tracking appointments and ensuring documentation is retrieved from appointments and placed in appropriate electronic record, as well as the Soldier’s hard copy medical record.
  • Assists Case Management staff in accordance with regulatory guidance for a Soldier’s care from the receipt of the condition to when the Soldier is deployable or the documentation is sent to the Health Services Specialist (HSS) for a Fitness for Duty evaluation where appropriate or to a MEB/PEB or Personnel Board. Will then assist the Soldier in coordination with the HSS to facilitate the expeditious processing through the appropriate medical board.
  • Confirm the Soldier understands his/her responsibilities and obtains a release of information form. Provide information to Soldiers about their privacy rights, how their information can be used and have Soldier(s) sign consent form(s).
  • The Contractor shall also be responsible for protecting the confidential nature of Soldiers’ files and medical issues.
  • Assist the NYARNG Surgeon’s Office in maintaining Soldier medical records in accordance with Army Regulation (AR) 40-66.
  • Assist the NYARNG Surgeon’s Office in providing the Medical Records section with all relevant medical/dental documentation.
  • Proficient in Microsoft Word, Excel, PowerPoint and Outlook, and proficient with the use of the following; Module of the Medical Operational Data System (MODS) modules: Medical Non-Deployable (MND), Health Readiness Record (HRR), DENCLASS, Medical Data Protection System (MEDPROS), Line of Duty (LOD) and DOJPAAS 9
  • Assist Case Management staff in preparation of Line of Duty (LOD) paperwork for units for which they are responsible.
  • Assist Case Management staff with reviewing for accuracy MEDPROS data before MWE’s to assist with early identification of non-deployable Soldiers.
  • Assist Case Management staff with entering Individual Vouchers for identified Soldiers into the Automated Voucher System (AVS) in furtherance of a Soldier’s care plan.
  • Assist Case Management staff with handling all contacts and work closely with other offices on related medical issues.
  • Conduct monthly case review with Case Management staff and DSS.
  • Conduct monthly case review with representatives of the NYARNG Commands and Health Services with support from the DSS.
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