Nurse (Case Manager)

This Nurse (Case Manager) position is with Indian Health Service (Department of Health and Human Services) in Phoenix, AZ. This position is located at the Phoenix Indian Medical Center in Phoenix, AZ. Several vacancies across multiple specialized functional areas, Outpatient Clinical Care Coordination, Outpatient Case Management, Specialized Case Management (Diabetes & HIV). Incumbents provide advanced professional nursing care coordination, longitudinal case management services. Key duties: • Total Compensation Package - Check out IHS's outstanding total compensation package for this job: Registered Nurse Total Compensation | Pay (ihs.gov) Outpatient Nurse Clinical Care Coordinator Duties: Provides real-time clinical care coordination and nursing triage for patients with complex healthcare needs, determining appropriate disposition and escalating acute changes in condition to providers. Coordinates referrals, authorizations, specialty care, and follow-up services across healthcare settings to promote timely access and continuity of care. Coordinates transitions of care following hospitalization, including medication reconciliation, follow-up appointments, and resolution of barriers to the plan of care. Uses clinical data, registries, and patient care gaps to support panel management, targeted outreach, and clinic-level quality improvement activities. Outpatient Nurse Case Management Duties: Independently manages an assigned caseload of patients with chronic, recurring, complex, or multi-system health conditions requiring longitudinal case management. Conducts comprehensive nursing assessments and develops, implements, evaluates, and modifies individualized care plans based on clinical, psychosocial, cultural, and resource needs. Coordinates services and transitions of care across providers, healthcare facilities, tribal programs, and community resources to address complex barriers and promote continuity of care. Serves as a clinical resource on complex case management issues and uses patient outcomes and program data to recommend improvements to case management practices, policies, and procedures. Diabetes Case Management Duties: Provides comprehensive case management for patients with diabetes, including screening, assessment, care planning, implementation, monitoring, and reassessment. Develops individualized care and service plans with patients, families, and the interdisciplinary healthcare team based on identified needs and available resources. Coordinates healthcare services across PIMC, other service units, contract providers, tribal programs, and community resources to promote continuity of care. Monitors patient progress and outcomes, revises care plans as needed, and provides patient education and advocacy to promote self-management and effective use of healthcare resources. HIV Case Management Duties: Provides comprehensive HIV case management across inpatient, outpatient, contract, and community settings to promote continuity of care from pre-admission through post-discharge. Conducts comprehensive assessments and develops individualized care and service plans in collaboration with patients, families, interdisciplinary teams, and community providers. Monitors and reassesses patient needs, treatment plans, services, and outcomes and coordinates ongoing healthcare and community resources. Provides patient advocacy and specialized HIV case management support related to treatment adherence, prevention, outreach, counseling, and continuity of care. This is a competitive vacancy announcement advertised under Direct Hire Authority. Selections made under this vacancy announcement will be processed as new appointments to the civil service. Current civil service employees would therefore be given new appointments to the civil service; however, benefits, time served, and all other Federal entitlements would remain the same. IHS Selectees whose duties and responsibilities require them to work permanently, temporarily, or occasionally in an IHS healthcare facility must comply with the IHS Employee Immunization Policy related to vaccine-preventable diseases, consistent with recommendations for healthcare workers. Vaccine exemption requests may be available, as outlined in the IHS Employee Immunization Policy and facility guidance. Qualifications: 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): Individual Occupational RequirementsGeneral Schedule Qualification Standards - Nurse Series 0610 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 Programs, Accreditation Commission for Midwifery Education, or an accrediting body recognized by the U.S. Department of Education at the time the degree was obtained. Must submit copy of transcript. Applications will be considered incomplete without proof. 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. Applications will be considered incomplete without proof. 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. Must submit copy of nursing license that includes an expiration date. Applications will be considered incomplete without proof.In addition to the above requirements, applicants must meet one of the following requirements: Basic Requirements for the GS-11 (or equivalent) Grade Level: Successful completion of a PhD or equivalent doctoral degree from a professional nursing educational program or related medical science field; OR Your resume must demonstrate 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. Examples of experience include: Care Coordination & Case Management: Managing an assigned caseload of patients with chronic, complex, or multi-system health conditions; conducting comprehensive nursing assessments; developing and modifying multidisciplinary care plans; and coordinating care transitions, specialty referrals, and prior authorizations across acute, outpatient, tribal, or community resources. Specialized Disease Management (Diabetes / HIV): Delivering comprehensive, disease-specific nursing case management for patients with chronic conditions (such as Diabetes Mellitus or HIV/AIDS); evaluating treatment adherence; providing patient and family education for self-management; and collaborating across multidisciplinary teams to eliminate care barriers. You must meet all qualification requirements within 30 days of the closing date of the announcement. View the full announcement and apply on USAJOBS.gov.