Near Patient Nurse

Humana International Group (Yamaguchi, 日本) フォロー 5日前

As per the TRICARE contract, the near-patient Nurse will be considered the main executor of the near-patient Program's in-country medical services.

Clinical: The role of the Near Patient Nurse is to provide medical case management and communication when a Prime or Prime Remote beneficiary is sought in the overseas Purchased Care Sector Provider (PCSP). The Near Patient team will work collaboratively with the PCSP, in-country US Military Facility/s, and the Near Patient Team to manage the episode of care keeping the beneficiary at the center of all considerations. Escalations to senior Near Patient Team members as determined by the medical situation will be required based on the clinical situation.

Governance: In addition, the Near Patient Medical Nurse will closely associate with the Clinical Quality Team and the organization underneath it on the quality and safety of providers, including auditing and credentialing TRICARE providers in a given area. The Near Patient Nurse may assist in gathering information to include those contained within the CQMP. The Near Patient Nurse may be the main point of contact for clinical quality assessment and feedback for individual care episodes, ongoing quality assurance of providers, and formal provider assessments.

Key Requirements include:

Near Patient Nurse to be located near key locations / MTF
Working under a centralized duty roster system and where applicable, participating in on-call duties which can include weekends plus after-hours
Near Patient Nurse to remotely support other TRICARE regions as required such as project work and medical support as required
Participate in routine MTF meeting/event attendance, and regular contact with MTF personnel to discuss medical cases
Perform regular provider visits and inspections, contact with providers to obtain medical updates
Ability to comfortably provide direct face-to-face plus telephonic beneficiary support
Ability to work proficiently with the TRICARE CRM system and provide SOAPe updates within the contractual/internal KPIs
Manage caseload independently within the International SOS TRICARE policies and procedures for both prime and prime remote cases 2
Escalate as required to senior in-country Near Patient team members including team leads, physicians, and or medical director to discuss/highlight case complexities/challenges
Work together with Quality Assurance Teams to support Quality Assurance initiatives and case-specific potential quality incident investigations and events. This will include compliments and complaints plus service recoveries

Additional Responsibilities:

Maintain accurate records including statistical information and client reports using the computer system made available by the organization.
Available to assist or participate in other projects or tasks where necessary
Be able to attend a regional TOP Center for training, including promoting communication with operations/medical/GAN staff to support the delivery of a seamless service and to ensure embedding of the International SOS values and ethos.

Qualifications:

Registered General Nurse or equivalent with a minimum 3 years of experience with registration to practice in the country of work
Able to communicate in Japanese language and English
Experience in working under a Code of Professional Conduct (knowledge of confidentiality etc.)
Experience with Microsoft Office software
Experience across a range of in-hospital clinical experience
Clinical experience and ability to audit healthcare providers in different environments and countries Knowledge/Skills
Living in Iwakuni or near Iwakuni base camp or willing to relocate

Desirable:

Experience working with new technologies in health care practice and of clinical coding ICD 10 and when required procedure codes
Active and unrestricted driver's license

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