Spv NCM PD

ARMY POSITION DESCRIPTION
PD#: DNMC341344 Sequence#: VARIES Replaces PD#:
NURSE (CLINICAL/CASE MGMT)
GS-0610-12
POSITION LOCATION:
Servicing CPAC: FORT BRAGG, NC Agency: VARIES
Installation: VARIES Army Command: VARIES
Region: SOUTH CENTRAL Command Code: VARIES
POSITION CLASSIFICATION STANDARDS USED IN CLASSIFYING/GRADING
POSITION:
Citation 1: OPM PCS NURSE SERIES, GS-610, JUN 77
Supervisory Certification: I certify that this is an accurate statement of the major duties
and responsibilities of this position and its organizational relationships, and that the
position is necessary to carry out Government functions for which I am responsible. This
certification is made with the knowledge that this information is to be used for statutory
purposes relating to appointment and payment of public funds, and that false or
misleading statements may constitute violations of such statutes or their implementing
regulations.
Supervisor Name: Reviewed Date:
Classification Review: This position has been classified/graded as required by Title 5,
U.S. Code in conformance with standard published by the U.S. Office of Personnel
Management or if no published standards apply directly, consistently with the most
applicable published standards.
Reviewed By: MEDCOM STANDARDIZED PD Reviewed Date: 04/06/2010
POSITION
INFORMATION:
Cyber Workforce:
l Cert Type/Level
Required 1: VARIES
CONDITION OF
EMPLOYMENT:
Drug Test Required:
VARIES
Financial Management
POSITION
ASSIGNMENT:
Competitive Area:
VARIES
Competitive Level:
Page 1 of 9Position Description
5/20/2015https://acpol2.army.mil/ako/fasclass/search_fs/search_fs_output.asp?ccpo=DN&jobNum=...

l Cert Type/Level
Required 2: VARIES
l Cert Type/Level
Required 3: VARIES
FLSA: EXEMPT
FLSA Worksheet: EXEMPT
FLSA Appeal: NO
Bus Code: VARIES
DCIPS PD: NO
l Mission Category:
l Work Category:
l Work Level:
Acquisition Position: NO
l CAP:
l Career Category:
l Career Level:
Functional Code: 81
Interdisciplinary: NO
Supervisor Status:
VARIES
PD Status: VERIFIED
DCA Override: NO
Certification: VARIES
Position Designation:
VARIES
Position Sensitivity:
VARIES
Security Access: VARIES
Emergency Essential:
Requires Access to
Firearms: VARIES
Personnel Reliability
Position: VARIES
Information Assurance:
N
Influenza Vaccination:
YES
Financial Disclosure: NO
Enterprise Position:
VARIES
VARIES
Career Program: VARIES
Career Ladder PD: NO
Target Grade/FPL: 12
Career Pos 1:
Career Pos 2:
Career Pos 3:
Career Pos 4:
Career Pos 5:
Career Pos 6:
POSITION DUTIES:
THIS IS A STANDARDIZED MEDCOM POSITION DESCRIPTION. DO NOT MAKE ANY
CHANGES TO THIS PD WITHOUT MEDCOM CHRD APPROVAL.
Serves as a Nurse Case Manager in order to provide professional case management and
health planning services. The incumbent of this position serves as a member of a
multidisciplinary team to provide assessment, planning, implementation, coordination,
evaluation, and monitoring of patients for health options and services. The incumbent
helps develop, analyze, integrate, monitor, and manage healthcare delivery systems
Through communication and use of resources to promote quality and cost-effective
outcomes across the continuum.
1. Provides advanced practice clinical nursing, administrative and organizational skills in
managing the continuity of care for the beneficiary populations. Conducts a
comprehensive assessment of beneficiary’s health needs in order to develop a plan of
care. Plans with the patient, the Family, the primary care physician/provider, other
healthcare providers, the payer, and the community, to maximize healthcare response
and quality, cost effective outcomes. Facilitates communication and coordination between
members of the healthcare team. Educates both the patient and members of the

healthcare delivery team about case management, healthcare and treatment options,
community resources, insurance benefits, psychosocial concerns, etc., so that informed
decisions can be made. Engages in problem-solving, exploring options to care when
available and alternative plans when necessary to achieve desired outcomes. Encourages
appropriate use of healthcare services and strives to improve quality of care and maintain
cost effectiveness. Empowers patients and serves as an advocate for both patients and
the healthcare team to facilitate positive outcomes.
60%
2. Provides oversight and input to nursing practice matters. Incumbent participates in the
identification of processes, systems, and practice metrics; and in determining measures of
care outcomes for the population served.
a. Attends multidisciplinary meetings, identifies potential case management clients
through health planning assessments, review of the multiple databases and points of
contacts available for the specified population. This screening process may include, but is
not limited to the Emergency Department log, physicians, nurses, Managed Care and the
clients themselves.
b. Screens all potential case management clients within established timeframe after
identification for appropriateness/benefit of case management services to client and/or
institution.
c. Interviews and counsels potential case management clients within established
timeframe as to services needed to optimize current health/psychosocial status and
benefits of case management services. Once the client accepts case management, the
approved metrics will be entered into a prescribed database for tracking purposes along
with clinical progress notes on the client's status.
d. Introduces innovative nursing techniques, practices, and approaches in collaboration
with health care providers to identify, assess, educate, plan, and coordinate care through
programs designed to provide efficient, comprehensive and cost effective service for case
managed patients.
e. Coordinates with patient-focused multidisciplinary teams of clinicians to develop time
line protocols/clinical guidelines which delineate the expected process of care delivery for
selected case managed patients and provide high quality affordable health care to its
beneficiaries. Monitors exceptions, deviations, and differences from the established
protocols to identify and report problems. Variances are analyzed and reported through a
continuous process improvement channel to seek solutions and improve delivery of care.
Accountable for coordination of care for select groups of complex patients to ensure
desirable patient outcomes are achieved. Consults and coordinates with other multi-
disciplinary care professionals, agencies, organizations, and other ancillary support
systems to assist patients to optimize their level of function and self care.
f. Conducts extensive evaluation of case management patients to establish in detail and
specificity the nature of their continuity of care needs as well as causal and contributing
conditions and circumstances. Conducts comprehensive clinical interviews with the patient
and other family members, as warranted, collects data from all involved health care
agencies, medical providers and resource programs. Participates in a multidisciplinary
team to develop a treatment plan to deal with all identified conditions and problems.
Identifies psychosocial aspects of anticipated care needs to identify potential barriers to
optimal health and resource utilization. Identifies methods for minimizing such barriers
and assists the patient and the family in developing and implementing appropriate care

plans, and accessing agencies and care providers.
g. Interfaces with local, state and federal agencies responsible for financing alternative
programs such as Home Health Care which DoD beneficiaries may be entitled to receive.
Obtains regulations, policy manuals and handouts from these agencies and develops
procedural guidelines to provide access to these programs in concert with TRICARE or
other governmental or private insurance coverage.
h. Identifies problems with health care access and utilization in both the military and
civilian sectors and recommends alternatives to overcome these difficulties. Problem areas
addressed may include admissions, outpatient visits, bill charges, acquisition of
equipment and services, patient complaints and inquiries as well as population health, and
quality improvement issues.
i. Assists in identifying strategies designed to improve patient access, improve adherence
to population health metrics, and reduce administrative burdens for DoD beneficiaries and
improve the cost effectiveness for the civilian/military health care delivery system.
Obtains feedback from the Fiscal Intermediary, TRICARE and the Health Care Finders to
identify problem areas. Proposes regulatory and administrative changes to resolve
identified problems.
j. Provides guidance on establishing appointment protocols to match patients' needs with
available resources in a timely manner. Coordinates with the medical staff to determine
medical appropriateness of selected appointment alternatives in relation to timeliness of
available care.
k. Develops guidelines for interfacing with the Health Care Finder Service with the
equivalent functions of the civilian health care delivery system supporting TRICARE.
Ensures guidelines are in compliance with program goals and that the medical staff of
both the military and civilian facilities is informed of these guidelines.
l. Acts as Nurse Consultant through holistic approach to address health care needs in
collaboration with all health team members to include the patient and the patient's family
as warranted. Provides education and clinical assistance through advanced nursing
knowledge, skills and techniques to nursing personnel, medical students,
interns/residents, staff physicians and administrators. Duties include formal and informal
consultation, briefings and informal/formal educational offerings. Provides first level
review of DME and Home Health consults and coordination of civilian care transfers.
Represents the Medical Management Service on or before a variety of committees,
boards, agencies, and concerned groups. Represents and serves as an advocate for the
program, patients, and their families in obtaining services and support for their special
needs.
m. Directs and manages a case managed patient population.
30%
3. Supervisory duties: Assign work to subordinates based on priorities, difficulty of
assignments, and the capabilities of employees. Provide technical oversight. Develop
performance plans and rate employees. Interview candidates for subordinate positions;
recommend hiring, promotion, or reassignments. Take disciplinary measures, such as
warnings and reprimands. Identify developmental and training needs of employees;
provide and/or arrange for needed development and training.
10%

PERFORMS OTHER DUTIES AS ASSIGNED.
CONDITIONS OF EMPLOYMENT:
THIS POSITION IS COVERED BY THE CIVILIAN DRUG ABUSE TESTING PROGRAM.
INCUMBENT IS REQUIRED TO SIGN A DA FORM 5019-R, AND/OR DA FORM 7412
"CONDITION OF EMPLOYMENT FOR CERTAIN CIVILIAN POSITIONS IDENTIFIED AS
CRITICAL UNDER THE DRUG ABUSE TESTING PROGRAM."
THIS IS AN INCLEMENT WEATHER ESSENTIAL POSITION: INCUMBENT IS EXPECTED TO
MAKE EVERY ATTEMPT TO REPORT FOR DUTY ON TIME AND/OR REMAIN ON DUTY
DURING SEVERE WEATHER CONDITIONS.
THIS JOB MAY ON OCCASION ENTAIL EVENING AND WEEKEND DUTY. THIS JOB MAY
ENTAIL OCCASIONAL VISITS TO PATIENT'S HOME OR OTHER TREATMENT FACILITIES AS
PART OF CASE MANAGEMENT FUNCTION.
CHILD CARE BACKGROUND CHECK REQUIRED FOR THIS POSITION.
FACTOR 1 KNOWLEDGE REQUIRED BY THE POSITION FL 1-7 1250 PTS
Professional knowledge of a wide range of nursing concepts and principles IAW Standards
of Nursing Practice, as well as extended experience with case management practices and
procedures to analyze the full scope of problems associated with providing appropriate,
cost effective care to DoD beneficiaries. This clinical knowledge is applied to solve both
administrative and professional health care problems relating to all case managed health
care.
Professional knowledge of nursing theory, hospital administrative operations and
procedures and how they interact with clinical and administrative information systems,
which includes matters pertaining to budget, personnel, credentialing, and an
understanding of the configuration and management of hospital data and information of
patient care, demographics, workload, and costs.
Knowledge of principles of healthcare provided to psychiatric, disease, and injury
casualties during military operations across all healthcare functional areas in order to
develop comprehensive data collection strategies.
Professional knowledge and ability to identify performance metrics and measure
population health care outcomes.
Professional knowledge in the appropriate referral of cases to other clinicians and services
when indicated.
Ability to effectively communicate orally and in writing with health providers at all levels
and negotiates with outside providers/vendors for services and products.
Knowledge of the military and regional health care delivery systems, including the specific
characteristics/objectives/requirements of each system for use in developing nursing and
clinical workload and performance reports.
Knowledge, skill and ability to provide professional assistance to health care finders in
identifying patients' needs for referral to appropriate health care providers.

Knowledge, skill and ability to use basic office automation and information management
equipment and programs, (i.e., word processing, database, email, etc.) and to input,
track and evaluate data for outcome management purposes.
FACTOR 2 SUPERVISORY CONTROLS FL 2-4 450 PTS
Receives general supervision. Supervisor provides general guidance and defines overall
objective and policies. Incumbent plans and carries out work independently in accordance
with general guidance, policies and previous experience. Coordinates with agency and
community officials and resources. Develops plans for study and carries through to
completion with recommended action resulting from study. Work review is in terms of
effectiveness in meeting program objectives, initiatives employed and soundness of
judgment exercised.
FACTOR 3 GUIDELINES FL 3-4 450 PTS
General guidelines and procedures exist but are not completely applicable to the case
managed client and every situation likely to be encountered. Based on patient population
targeted, incumbent develops, implements, evaluates and modifies multidisciplinary
patient care policies and procedures in conjunction with the Care Management Service
and the specialized Health Care Teams involved in the client's care. Incumbent
contributes to the modification of existing guidelines or policies through participation in
studies which often result in changes in treatment procedures, policies and services. In
the absence of existing guidelines, the incumbent must exercise judgment, knowledge
and ingenuity in establishing protocol, organization and activities pursuant to solving the
problem at hand. The employee must exercise initiative and resourcefulness in carrying
out assigned clinical, administrative and supervisory responsibilities.
FACTOR 4 COMPLEXITY FL 4-5 325 PTS
The work includes varied duties requiring many different and unrelated processes and
methods applied to a broad range of substantial depth of analysis and independently
performing difficult and complex reviews and analysis of case managed situations to
assess and evaluate specific provisions of health care, along with other criteria. Decisions
regarding what needs to be done include major areas of uncertainty in approach,
methodology, or interpretation and evaluation processes resulting from such elements as
continuing changes in technological developments in the nursing or medical field.
Independently performs difficult and complex reviews and analysis of case managed
situations to assess and evaluate specific provisions of health care. Requires extensive
experience in dealing with and resolving problems relating to direct and indirect
healthcare issues requiring consideration of both. Exercises considerable resourcefulness
and judgment to implement modifications to existing procedures or to develop new and
innovative procedures to improve services and resource utilization.
FACTOR 5 SCOPE AND EFFECT FL 5-4 225 PTS
The purpose of the work is to provide a medically-oriented professional evaluation of case
management services, medical and nursing support as well as administrative services and
products provided to assess the efficiency, effectiveness and economy of those services
and products and to identify, recommend and implement improvements as deemed
appropriate. Also, provides direction to health care providers and assistance to patients in
obtaining health care benefits. The work significantly impacts the overall provision of
health care treatment and services in the catchment area.

FACTOR 6 PERSONAL CONTACTS FL 6-3 60 PTS
Contacts include DA and DoD personnel, utilization management officials, community
assistance agencies, contract services and product delivery agency. Contacts are with
individuals or groups from outside the employing agency to include high level officials
such as DA and DoD personnel in a moderately unstructured setting. Personal contacts
are with selected patients and their families, healthcare providers and treatment planners
from within and outside the agency.
FACTOR 7 PURPOSE OF CONTACTS FL 7-3 120 PTS
Contacts are to coordinate, plan and facilitate patient evaluation and treatment and
conduct training on the implementation of patient care maps, discuss treatment policies;
discharge planning and possibilities for procedural changes. Through the training program
execution, the incumbent will be responsible for training and guidance to all levels of
health care providers. Some contacts are for negotiating agreements and influencing
modifications to existing procedures, to assess patient needs, and to advise on or
coordinate internal and external actions.
FACTOR 8 PHYSICAL DEMANDS FL 8-1 5 PTS
Some walking, standing, bending, and carrying light items and driving an automobile to
conduct external business. The work is stress related and requires emotional stability and
maturity in the face of crisis intervention and/or prolonged anxiety.
FACTOR 9 WORK ENVIRONMENT FL 9-1 5 PTS
Work involves normal everyday risks or discomforts typical of offices, meeting rooms,
etc., which am adequately heated, lighted and ventilated. While some biological and/or
radiological hazards may be present, such areas are clearly marked so that protective
measures can be taken.
TOTAL POINTS: 2890
POINT RANGE: 2755-3150
GS-12 PHYSICAL EXAM MAY BE REQUIRED.
This position has a mandatory seasonal influenza vaccination requirement and is
therefore subject to annual seasonal influenza vaccinations. Applicants tentatively
selected for appointment to this position will be required to sign a statement
(Condition of Employment) consenting to seasonal influenza vaccinations.
ALL EMPLOYESS ASSIGNED TO A MTF ARE REQUIRED TO BE SCREENED FOR
APPLICABLE IMMUNIZATIONS REGARDLESS OF SERIES, BASED ON
OCCUPATIONAL RISK, AND ARE SUBJECT TO MISSING/REQUIRED
IMMUNIZATIONS IAW AR 40-562, CHAPTERS 3 & 4.
PHYSICAL EXAM MAY BE REQUIRED
Fair Labor Standards Act (FLSA) Determination = (EXEMPT)
1. Availability Pay Exemption - (e.g., Criminal Investigators, U.S.

Customs and Border Protection pilots who are also Law Enforcement
Officers).
2. Foreign Exemption - (Note: Puerto Rico and certain other locations
do not qualify for this exemption – See 5 CFR 551.104 for a list of
Nonexempt areas.)
3. Executive Exemption:
a. Exercises appropriate management responsibility (primary duty)
over a recognized organizational unit with a continuing function,
AND
b. Customarily and regularly directs 2 or more employees, AND
c. Has the authority to make or recommend hiring, firing, or other
status-change decisions, when such recommendations have
particular weight.
Note: Shared supervision or “matrix management” responsibility for a
project team does not meet the above criteria. Limited “assistant
manager” functions or “acting in the absence” of the manager does not
meet the above criteria.
4. Professional Exemption:
a. Professional work (primary duty)
b. Learned Professional, (See 5 CFR, 551.208 ) (Registered Nurses,
Dental Hygienists, Physician’s Assistants, Medical Technologists,
Teachers, Attorneys, Physicians, Dentists, Podiatrists, Optometrists,
Engineers, Architects, and Accountants at the independent level as
just some of the typical examples of exempt professionals). Or
c. Creative Professional, (See 5 CFR, 551.209 ) (The primary duty
requires invention and originality in a recognized artistic field
(music, writing, etc.) and does not typically include newspapers or
other media or work subject to control by the organization are just
some examples of Creative Professionals). Or
d. Computer Employee, (See 5 CFR, 551.210 ) ( must meet salary
test and perform such duties as system analysis, program/system
design, or program/system testing, documentation, and
modification). Computer manufacture or repair is excluded (non-
exempt work).
5. Administrative Exemption:
a. Primary duty consistent with 5 CFR 551 (e.g.; non-manual work
directly related to the management or general business operations
of the employer or its customers), AND job duties require exercise
of discretion & independent judgment.
FLSA Conclusion:
Exempt
Non Exempt
FLSA Comments/Explanations:

Duties 1, 2 and 3 meet the exemption criteria.
CONDITIONS OF EMPLOYMENT & NOTES:
POSITION EVALUATION:
Not Listed

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