Job Description
Based in the San Antonio, TX, Regional Contact Centre (RCC), the TRICARE Nurse Manager will be responsible for the delivery of professional and effective medical assistance services for TRICARE beneficiaries in the Latin America-Canada region in compliance with TRICARE guidelines and TOP Contract specifications and expectations, maintaining International SOS highest standards of excellence.
Qualifications:
- Current and unrestricted license from any US State, District of Columbia or US Territory to provide healthcare within scope of practice
- Bachelor Degree in Nursing from an accredited US nursing program.
- Minimum of 5 years experience as a RN; minimum 3 years in a supervisory role
- Military health care system experience preferred
- Experience of managing/coordinating international evacuations a distinct advantage
- Ability to obtain ADP II Clearance after accepting position with Intl SOS
Key Responsibilities
- Ensure that professional, customer-focused and quality service is provided through oversight and direction of the TRICARE Medical Team
- Oversee the allocation and progression of work for the team. This involves properly allocating transmissions and cases to team members of appropriate capability and ensuring that tasks and actions are completed within expected timeframes.
- Assist the TRICARE Medical Director by monitoring progress on complex or high-priority cases to ensure that all service standards are met.
- Responsible for confirming that adequate staff coverage is scheduled to support case management.
- Coordinate the monthly schedule and upload any changes on the roster to the master schedule
- Validate time sheets and monitor PTO time through ADP EZLabor Manager.
- Serve as a role model and provide professional and technical coaching to members of the team.
- Manage any tasks as may be required when staffing may be deficient.
- Coordinate the agenda and chair TRICARE Medical Team meetings.
- Monitor the completeness and accuracy of medical notes entered into CRM and case direction provided by the Medical Team as may be required when issues regarding individual case management arise.
- Drive the focus on quality of data capture, accuracy of recommendations and case direction within the framework of case management.
- Proactively manage cases and direct cases escalated to her with a focus on medical actions that lead to effective case management and patient oversight.
- Act as the primary point of technical expertise for the Medical Team providing guidance and advice to resolve conflicts and issues and escalating to the appropriate resource for assistance as may be necessary.
- Strategically review staffing model to ensure it supports the TRICARE platform providing metrics and numbers to justify new staffing models as may be required to support caseload and maintain quality standards. This includes budgeting new positions based on projected membership usage, business growth, and staff attrition.
- Ensure that communication, coaching, and training requirements are coordinated so that any workflow or quality issues can be addressed promptly.
- Provide input and participate in related projects, as may be necessary, taking the lead relative to individual level of comfort and experience.
- Ensure that medical team follows job description items pertaining to medical assistance responsibilities, medical advice and reporting, referrals, medical transportation, and GAN support.
- Work flexible hours as appropriate to case management and requirements of the position.
STAFF SUPPORT AND DEVELOPMENT
- Oversee senior nurse coordination of induction training and learning and development across the platform.
- Ensure that peer RN mentors give weekly feedback to the new staff members and to the Nurse Manager.
- Participate in performance reviews quarterly in preparation for the annual review.
- Ensure that any level of staff under-performance is identified and addressed. This may include escalation to the Medical Director, feedback to the staff member, implementation of performance improvement plan and coordination of appropriate additional training and support, as needed.
- Maintain appropriate documentation of any actions taken regarding individual performance and address any disciplinary or grievance matters in accordance with International SOS policies and procedures.
- Ensure staff attendance at Biweekly medical team meetings and daily transmissions.
- Develop new ideas and projects for training, quality assurance, and staff motivation.
- Ensure that the TRICARE nurses actively pursue their Continuous Professional Development and that they are supported in their pursuit of such opportunities.
- Encourage good working relationships with the operations team and act as liaison with other departments by supporting regular staff meetings if requested.
- Actively recognize high-performing staff and create development plans to address their specific strengths, keeping the TRICARE Medical Director updated on these developments.
- Carry out any other reasonable duties as requested by the TRICARE Medical Director.
CASE ESCALATION
- Escalate cases as per Intl. SOS protocol to the TRICARE Medical Director, Senior Medical Director – TOP Remote Assistance Services, TOP Global Medical Director, and Corporate Assistance Department (CAD), in that order respectively.
QUALITY AND TRAINING
- Provide medical monitoring of ongoing cases and ensure excellence in case management, with a focus on encouraging optimal quality and efficiencies across the platform.
- Act as front-line point of contact for active service recovery handling complaint calls and coordinating recovery for complaints received; this includes participating in the Quality Review process and service recovery for those cases where quality measures were not maintained or based on feedback from external sources.
- When a service quality defect reflects Medical Team involvement, review the nature of the complaint and address the issue directly with the MT involved to ensure constructive criticism and feedback are reflected and changes implemented so that the service deficiency is not repeated.
- Maintain strategic direction and a strong interface with the clinical training team to regularly review material and deliverables for the TRICARE nursing team. Identification of trends and analysis to determine required support.
- Use initiative to implement ways of improving quality and efficiency proactively.
- Maintain overall accountability for the training and induction of the nursing team along with MD.
Miscellaneous
- Undertake client-specific training on unique software or program requirements to fulfill the expectations of the contract and client.
- Be responsible for personal and Continuing Professional Education.
- Attend supervision, training, and departmental meetings as may be required.
- Maintain accountability for personal workload.
- Participate in Peer-Mentor, Training-Mentor, and similar programs as may be requested.
Job Profile:
Required Competencies
- Writing & Reporting: Writes clearly, succinctly, and correctly; Writes convincingly in an engaging and expressive manner; Avoids the unnecessary use of jargon or complicated language; Writes in a well-structured and logical way; Structures information to meet the needs and understanding of the intended audience
- Delivering Results & Meeting Customer Expectations: Focuses on customer needs and satisfaction; Sets high standards for quality and quantity; Monitors and maintains quality and productivity; Works in a systematic, methodical, and orderly way; consistently achieves project goals.
- Adapting & Responding to Change: Adapts to changing circumstances accepts; new ideas and change initiatives; Adapts interpersonal style to suit different people or situations; shows respect and sensitivity towards cultural and religious differences; Deals with ambiguity, making positive use of the opportunities it presents.
- Leadership: Upholds ethics and values; Demonstrates integrity; Establishes effective relationships with clients and staff; Motivates and empowers others; Effective communication which encourages clear dialogue, debate, and reflection to promote and discuss ideas in the pursuit of positive outcomes.
- Coping with Pressure: Works productively in a pressurized environment; Keeps emotions under control during difficult situations; Balances the demands of a work life and a personal life; Maintains a positive outlook at work; Handles criticism well and learns from it.
- Working with People: Demonstrates an interest in and understanding of others; Adapts to the team and builds team spirit; Recognizes and rewards the contribution of others; Listens, consults others, and communicates proactively; Supports and cares for others; Develops and openly communicates self-insight.
Required Work Experience
- Minimum of 5 years experience as an RN; minimum of 3 years in a supervisory role
- Military health care system experience preferred
- Experience in managing/coordinating international evacuations is a distinct advantage
Required Education
- Current and unrestricted license from any US State, District of Columbia, or US Territory to provide healthcare within the scope of practice.
- Bachelor Degree in Nursing from an accredited US nursing program
Required Qualifications
- Ability to obtain ADP II Clearance after accepting a position with Intl SOS
Additional Information
International SOS Government Medical Services is an equal opportunity employer and does not discriminate against employees or job applicants on the basis of race, color, religion, gender, sexual orientation, gender identity, national origin, age, disability, genetic information, marital status, amnesty or status as a covered veteran in accordance with applicable federal, state and local laws.
Compensation | Min:90,000 Max: 105,000
Pay range is based on several factors and may vary in addition to a full range of medical, financial, and/or other benefits. Final salary and offer will be determined by the applicant’s background, experience, skills, internal equity, and alignment with geographical market data.
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