Attachment 2 - Positions Descriptions.pdf

ALLERGIST

(Personal)

1.0. QUALIFICATIONS

1.1. Completion of a fellowship in allergy acceptable to the Surgeon General, Headquarters United States Air Force, is mandatory.

1.2. Must possess and maintain a current, unrestricted and active license to practice medicine without adverse action, or limitations from any state or federal entity.

1.3. Board Certification in Allergy/Immunology.

1.4. Minimum two years of clinical experience post fellowship.

1.5. Working knowledge of computer operations and proficiency in the use of basic word processing, data entry and electronic medical records.

1.6. Must be competent in the interpretation of allergy testing to include: skin prick testing, intradermal testing, patch testing and serum Immunoglobulin E (IgE) testing for aeroallergens, foods, medications, and venom antigens.

1.7. Must be competent in the interpretation of pulmonary function testing/spirometry, exhaled nitric oxide, and the diagnosis of asthma and other allergic/IgE mediated diseases of the respiratory tract.

1.8. Possess and maintain current certification in Basic Life Support (BLS) in accordance with 355 Medical Group (355 MDG) policies. Advanced Cardiac Life Support (ACLS) and Pediatric Advanced Life Support (PALS) is highly desirable.

1.9. Have knowledge of vaccination procedures and proper administration of intradermal, subcutaneous, and intramuscular injections.

1.10. Have working knowledge of how to set up, operate, and monitor specialized medical equipment such as;

Intravenous (IV) infusion pumps, cardiac monitoring devices, Electrocardiogram (EKG), oxygen analyzers, nebulizers, pulmonary function tests, and other clinic specific equipment.

1.11. Must have a mature command of speaking, writing and reading in the English language.

2.0. CORE DUTIES

2.1. Provide professional medical care for TRICARE beneficiaries who present with allergic conditions and immunization needs.

2.2. Review referrals for allergy services and appropriately disposition patients to the medical treatment facility or a civilian institution based on services required.

2.3. Prepare and review case histories; obtain additional data through interviews and appropriate examination.

2.4. Accurately request/order required imaging, clinical laboratory testing, and diagnostic allergy testing.

2.5. Provide clinical oversight to all diagnostic testing performed in the Allergy Clinic to ensure quality and accuracy.

2.6. Properly diagnose allergic conditions based on testing and evaluations.

2.7. Create appropriate treatment plans to address allergic disorders including appropriate use of medications, diets, and recommendations for immunotherapy when indicated.

2.8. Create and order an appropriate immunotherapy prescription and schedule using the Extract Lab Management

System (ELMS).

2.9. Provide clinical oversight in the preparation and administration of allergy serum, including the ability to perform ten-fold serial dilutions of extracts and administer immunotherapy in the absence of nursing staff, if required.

2.10. Ensure timely and accurate documentation and coding of allergy treatments/procedures in patient and clinic records.

2.11. In emergencies, treat patients suffering from anaphylactic shock, angioedema, urticaria, bronchospasm, and other severe allergic diseases. And ensure transfer to a higher-level facility is accomplished as clinically indicated.

2.12. Provide patient education on the allergy process, treatments, testing schedule, and possible negative outcomes if treatment schedule is not adhered too.

2.13. Oversee the clinical work of nursing/medical technician personnel assigned to the allergy clinic.

2.14. Ensure compliance with standards of care and practice in accordance with 355 MDG, Air Force Instructions (AFI), the Joint Commission (TJC) standards, and the Advisory Committee on Immunization Practices (ACIP) guidelines.

2.15. Implement universal infection control practices within the clinic.

2.16. Provide accurate and effective guidance/feedback to medical team members in a professional manner to facilitate team based clinical operations that result in effective, efficient, and cohesive patient care. Participate in orientation, training, and evaluation of duty performance of newly assigned personnel, as appropriate.

2.17. Screen telephonic, electronic, and in-person requests for patient care concerns, provides advice by telephone, secure messaging or in person, in accordance with 355 MDG, AFI, and ACIP policies.

2.18. With assistance from the Group Practice Manager (GPM) formulate appointment templates and schedules for allergy services/procedures, schedule clinic and allergic testing, and provide assignments to personnel as needed.

2.19. Advise support staff of the kind and quantity of allergy supplies and equipment needed, and have working knowledge of how to order supplies. Ensure appropriate storage and integrity of allergy supplies and equipment.

2.20. Set up, operate, and monitor specialized medical equipment in the absence of nursing support, if required.

2.21. Coordinate allergy services with other medical activities.

2.22. With the patient’s Primary Care Manager (PCM), be able to counsel Active Duty members on the impact of diagnosed allergic conditions on their military service.

2.23. Serve as consultant to other MTF providers regarding allergic conditions and their treatment.

2.24. May require bending, lifting, pushing, pulling and standing for prolonged periods of time as needed.

2.25. Actively participate in committees, functions, peer review, process improvements, huddles and meetings as directed or assigned.

2.26. Participate in local disaster training exercises as directed by the Chief of the Medical Staff (SGH) or Medical Group Commander; respond to real-world disaster situations.

2.27. Other additional related duties as assigned.

ALLERGY/IMMUNOLOGY LICENSED PRACTICAL NURSE

1.1. Licensed Practical Nurse. Successful completion of all education and training requirements leading to and graduating from an accredited national, state or military equivalent school for Practical Nursing.

1.2. Must have a minimum of 12 months of allergy experience, preferable in the last five years.

1.3. Must possess and maintain throughout course of contract, a current, active, valid, unrestricted license (with no limitations, stipulations or pending adverse actions) to practice as a Licensed Practical Nurse (LPN) from a US jurisdiction. License must be recognized and accepted by the State of practice in accordance with governing regulations. License cannot be under investigation nor have any adverse action pending from a State Board or national licensing/certification agency.

1.4. Possess and maintain a current certification in basic life support (BLS) in accordance with 355th Medical Group (355 MDG) policies. Current certification in Pediatric Life Support (PALS) and Advanced Life Support (ACLS) is highly desirable.

1.5. Must understand and be able to follow immunotherapy titration/administration schedules.

1.6. A strong understanding of vaccine schedules, tests of immunity and vaccine administration is mandatory.

1.7. Must have a mature command of speaking, writing, and reading the English language.

1.8. Must have strong working knowledge and skills to use a variety of computer systems. A strong working knowledge of the military health care system and computer documentation is highly desirable.

2.0. CORE DUTIES

2.1. Work under the general supervision of an Allergist or supervising credentialed provider and provide allergy treatments/procedures in the clinic in a safe and medically accepted manner as directed by the Allergist.

2.1.1. Properly administer vaccines according to written orders and protocols, to include intradermal, subcutaneous, and intramuscular injections. Properly documents vaccine administration and communicate follow-up requirements to patients.

2.1.2. Provide allergy treatments/procedures to include: skin prick/scratch test, intradermal injections, patch testing, preparation and administration of allergy serum, perform ten-fold dilutions of allergy serum extracts, perform peak flow assessments, perform spirometry with/without bronchodilators and use inspired nitric oxide device.

2.1.3. Document allergy treatments in patient record and initial record. Report any unusual reaction to treatment immediately to the allergist.

2.1.4. Monitor patient’s reaction to treatments and keep the allergist/supervising provider apprised of patient progress and any changes in health status.

2.2. The Allergy/Immunology LPN will provide comprehensive professional medical care for TRICARE enrolled beneficiaries ranging from newborn to geriatrics presenting with allergy conditions and immunization needs.

2.2.1. Introduce the patient to the clinic environment, initiate screening by a thorough review and update of the medical history, obtain and record physiologic measurements, and report findings to the provider or nurse.

2.2.2. Perform patient education in regards to treatment process, schedule, and possible negative outcomes if schedule is not adhered too.

2.2.3. Execute medical order and request diagnostic tests as directed by the provider.

2.2.4. Obtain diagnostic test results and outside consultations for the provider, and arrange follow-up patient care as directed by the provider. Request documents/makes copies of documentation as indicated.

2.2.5. Screen telephone, electronic, and in-person requests for patient care concerns, provide advise by telephone, secure messaging, or in person per 355 MDG approved protocols or as directed by the provider or nurse in assisting the patient to arrange treatment.

2.2.6. Administer oral, intramuscular and subcutaneous medications and vaccinations as directed by the provider only after completion of 355 MDG approved medication administration and/or Immunization training programs.

To include, ten-fold dilutions of extracts (allergens).

2.2.7. Perform nursing procedures within training and scope of practice.

2.2.8. Set up, operate and monitor specialized medical equipment such as Intravenous (IV) infusion pumps, cardiac monitoring devices, Electrocardiogram (EKG), oxygen analyzers, nebulizers, pulmonary function tests and other clinic specific equipment.

2.2.8. Ensure medication/supplies are ordered and replenished in a timely manner. Ensure extracts are ordered in advance to ensure they arrive prior to expiration of current doses.

2.2.9. Perform central sterile supply duties.

2.2.10. Promote preventive and health maintenance care through prevention counseling.

2.2.11. Assist providers with the paraprofessional portion of patient examinations, therapeutic measures, and procedures.

2.2.12. Identify and report cases which have public health significance per 355 MDG policy.

2.2.13. Assist in stabilizing patients in a medical emergency, ensuring appropriate care/transfer to a higher level facility is accomplished as clinically indicated.

2.2.14. Communicate orally and in writing with a diverse group of individuals (peers, health care team staff, patients), including clear, precise telephone and electronic communication. Document all clinical encounters and patient instructions into the patient’s medical record via the electronic medical record system in accordance with 355 MDG policy.

2.2.15. Ensure proper documentation/coding of procedures and treatments.

2.2.16. Ensure compliance with standards of care and practice in accordance with all established policies, procedures, and guidelines used in the medical treatment facility. Provide care within ethical and legal boundaries.

2.2.17. Serve/participate in committees, functions and other meetings as directed. Provide relevant and timely information to these groups, and assist with decision-making and process improvement. Participate in customer service initiatives, and medical readiness activities, designed to enhance health services.

2.2.18. Provide accurate and effective guidance and feedback to the medical team members in a collegial and professional manner to facilitate team based clinical operations that result in effective, efficient, timely and cohesive patient care.

2.2.19. Participate in the orientation and training of newly assigned Allergy/Immunization Clinic personnel/support staff, as appropriate.

2.2.20. Complete orientation and competency verification programs in accordance with unit/355 MDG guidelines.

2.2.21. Augment medical technician support during the absence of other team technicians due to illness, leave or deployment.

2.2.22. Participate in local disaster training exercises as directed by the Chief Nurse (SGN) or 355 MDG Commander; respond to real-world disaster situations.

2.2.23. Ensure a safe work environment and employee safe work habits. Implement universal infection control practices.

2.2.24. Other additional duties as assigned.

BENEFICIARY SERVICES REPRESENTATIVE/PHYSICAL

EVALUATION BOARD LIAISON OFFICER (PEBLO)

(Non-Personal)

1. QUALIFICATIONS

1.1. Ability to plan, organize, and manage functions and staff within a Military Treatment Facility (MTF) to meet program objectives. Knowledge of the military healthcare organizational structure, major issues, policies, procedures and operations related to the management of the healthcare delivery systems.

1.2. In-depth knowledge, experience, and training to handle and solve complex cases that arise when addressing fitness for duty or physical disability evaluation issues.

1.3. Tact, diplomacy, and restraint in counseling and explaining entitlements, benefits, and responsibilities to all customers.

1.4. Effective interpersonal communication skills to effectively accomplish the Integrated Disability Evaluation System (IDES) process

1.4.1. Master of oral and written communication and customer service principles, methods, practices and techniques analytic methods, to include using research tools and statistical analysis and, interpersonal relations practices.

1.4.2. Ability to communicate effectively both orally and in writing to motivate, train, and work effectively with a diverse workforce. Must be able to draw realistic conclusions and recommend viable solutions.

1.5. Ability to gather data from various sources, analyze data, statistical analysis, prepare statistical reports and recommendations for improvements.

1.6. Skill in applying fact finding, analytical, and problem solving methods and techniques.

1.7. Knowledge of Disability Evaluation System (DES) processing regulations, instructions, procedures, and policies to assure timely case processing.

1.8. Practical knowledge and understanding of the TRICARE program.

1.9. Education. Associate Degree in business administration, management or health care organizations from an accredited college or university.

1.10. Experience. Two years’ experience as a PEBLO within the Department of Defense (DoD) military health system in the last 6 years; or five years’ experience working in a civilian disability program; or two years’ experience as a Veterans Administration Medical Service Coordinator (MSC).

1.11. Work Environment/Physical Requirements. The work is primarily sedentary. Requirements include prolonged walking, standing, sitting or bending.

2. UNIQUE MILITARY HEALTH CARE COMPUTER SYSTEMS/PROCEDURES

2.1. The Air Force Medical Operations Agency (AFMOA) IDES support team will provide ongoing IDES training guidance.

2.2. PEBLO training will include: Orientation training, on-the-job training, standardized DES annual refresher or continuing education and training to ensure PEBLOs remain current in their understanding and application of DES procedures. Training will be accomplished via computer-based training, monthly teleconference, and ongoing email communications.

2.3. Training will be in accordance with Warrior Care Policy Training Standards and Performance Objectives Guidebook.

2.4. Veteran Tracking Application training will be provided by the Veterans Benefits Administration (VBA/DoD Collaboration Team) via DCS training.

2.5. Regulatory Guidance: Department of Defense Manual (DoDM) 1332.18 Vol 1, Disability Evaluation System (DES) Manual: General Information and Legacy Disability Evaluation System (LDES) Time Standards, Enclosure 5, DoDM 1332.18, Vol 2, Disability Evaluation System (DES) Manual: Integrated Disability Evaluation System (IDES), Enclosure 4, and Air Force Instruction (AFI) 41-210, TRICARE Operations and Patient Administration, Section 4K – Medical Evaluation of Service Members for Continued Military Service.

3. CORE DUTIES

3.1. Responsible for obtaining, assembling and forwarding all required documents and records for active duty, Air Force Reserve Component (AFRC) and Air National Guard (ANG) to the Veteran Affairs Medical Service Coordinator, the local Medical Evaluation Board (MEB), the Informal Physical Evaluation Board, the Formal Physical Evaluation Board (FPEB) and other IDES stakeholders in accordance with regulatory guidance.

3.1.1. Ensure Line of Duty (LOD) processing is accomplished for each IDES case.

3.2. Provide guidance to all ranks of military personnel from all branches of the uniformed services, retirees, and families of those being processed through the IDES program of their rights, benefits, privileges, or obligations.

3.3. Coordinate evaluation appointments; schedules follow-up appointments and appropriate referrals related to benefits.

3.3.1. When the service member is incapacitated or incompetent for pay purposes and unable to manage his/her own legal affairs, the PEBLO provides guidance and assists the legal next-of- kin on the service member’s rights and benefits.

3.4. Serve as a liaison between the service member, their respective commander and a multi-disciplinary team of primary care managers, other appropriate health care professionals, medical care case managers, non-medical case managers (e.g., Recovery Care Coordinators (RCC)), patient administration personnel, the Office of the Airmen’s Counsel (OAC), the Physical Evaluation Board (PEB) and the Military Department Wounded Warrior Program liaison or advocate.

3.4.1. Process Review-in-Lieu-of (RILO) MEB cases for assignment limitation codes as directed or required by Air Force Personnel Center, Medical Retentions and Standards Branch (AFPC/DP2NP) and in accordance with established Air Force guidance.

3.5. Receive and respond to inquiries from beneficiaries, DoD Components, other agencies, and various interested parties.

3.6. Provide guidance on activities with appropriate points of contact throughout the Military Health System (MHS), the line of the Air Force agencies, (i.e. Military Personnel Flights, Comptroller, Air Force Personnel Center (AFPC), Transportation, Aeromedical Evacuation) and the Department of Veterans Affairs (i.e. Veterans Benefits Administration (VBA) and Veterans Health Administration (VHA) to best meet the member’s needs for information or assistance.

3.7. Assist in preparing appeals, impartial medical reviews, rebuttals, and coordinates the assignment of Service member’s legal counsel.

3.8. Update local program documentation (i.e., patient handouts, training documents, checklists, operating procedures, etc.)

3.9. Maintain and safeguard both hard copy and electronic medical information.

3.9.1. Disclose medical information to authorized personnel in accordance with Privacy Act of 1974 and Health Insurance Portability and Accountability Act (HIPAA) guidelines.

3.10. Assist the medical professional staff and other staff members on the regulatory and procedural aspects of profiling and disability processing. Provide MEB orientation program and on the job training for assigned staff personnel as required.

3.11. Track all assigned cases, analyze performance against established standards.

3.11.1. Monitor/update cases in Veterans Tracking Application (VTA) or other tracking tool as the case progresses through the IDES process.

3.11.2. Analyze available data using various statistical analytic tools, measuring means, trends, statistical deviations, construct diagrams, histograms, charts, etc., to convey IDES performance to IDES stakeholders.

3.11.3. Provide reports, briefings, training and respond to inquiries from senior leaders.

3.12. Coordinate patient travel for members opting to appeal to the FPEB. Assure necessary arrangements are made for members to travel on temporary duty status to and from other locations as required.

3.12.1. Initiate actions to facilitate Emergency Family Member Travel for Very Seriously Ill and Injured Service members.

3.13. Advise service members and medical staff on PEB findings.

3.14. Assist in preparing appeals and rebuttals and coordinate the assignment of legal counsel.

4. SUMMARY. This position serves as the Physical Evaluation Board Liaison Officer for the MTF and its geographic area of responsibility. Provides DES guidance in accordance with established DoD guidelines, data collection, medical coordination, Service member/commander/stakeholder advising, and procedural work related to MEB processing and Temporary Disability Retired List (TDRL) reevaluations in accordance with applicable instructions, regulations and directives. Liaison support is provided to active duty and Reserve Component (RC) members, AFRC, ANG, and commanders on program requirements, military benefits, legal rights, and the appeals process. Coordinates Aeromedical evacuation or other patient travel requirements, fitness for duty determinations, LOD and other program requirements related to the DES. Provides PEB findings to service member and medical staff. Tracks each DES case from referral to final disposition. Guides the Service member throughout the DES process.

BIOMEDICAL EQUIPMENT TECHNICIAN (BMET)

(Non-Personal)

1.1. Associate degree in Biomedical Equipment Technology, completion of the DoD Biomedical Equipment Technology Technical training, and/or AAMI Biomedical Equipment Technician certification.

1.2. At least two years of biomedical equipment technician experience.

1.3. Ability to communicate effectively, both orally and in writing. Ability to establish and maintain effective working relationships to represent the organization in a professional manner.

1.4. Knowledge of and skills in applying a wide range of specialized methods, principles, and techniques of electronic systems associated with complex medical system failures, recovery of systems, adjusting, modifying, and improving systems to include hardware and software components. Knowledge of and application skills also include, but not limited to: mechanics, pneumatics, hydraulics, and ionizing radiation.

1.5. Knowledge of a wide range of electronic principles and practices, operating parameters, capabilities, and limitations of electronic systems associated with complex medical systems/equipment; and of systems and component design, capabilities, configurations, limitations, and functional operation; and of various types of electronic logic.

1.6. Knowledge of The Joint Commission, College of American Pathologists (CAP), Occupational Safety and Health Act (OSHA), National Fire Protection Association (NFPA), National Electric Code (NEC), Food and Drug Administration (FDA) and other regulations, procedures, and practices as it applies to biomedical equipment.

1.7. Skill in the interpretation of technical data such as drawings, schematics, blueprints, and specifications of complete electronic systems; in analyzing problems in integrated/interfacing systems involving numerous complex circuits; and in using complex electronic and electromechanical test and measuring equipment using integrated test functions for different purposes.

1.8. Ability to maintain, repair, and test biomedical equipment in accordance with strict Original Equipment Manufacturer (OEM) technical compliance. Ability to solve technical and performance problems for highly complex electronic systems. Ability to trace electronics logic from one system to another.

1.9. Ability to use standard Air Force computers and software to enter and extract data to maintain records and document actions. Knowledge and ability to utilize the following Microsoft Office products: Outlook, Word and Excel.

1.10. Work Environment/Physical Requirements. Work will be accomplished in various departments of the medical treatment facility or logical extension of the facility (i.e. satellite clinic, health and wellness centers). Work areas may include isolated wards and in contaminated areas where personal protected equipment is required.

Occasionally work on live electrical wires, switches and transformers of various voltage levels, exposing the worker to the possibility of shock, cuts, bruises, scrapes and serious burns. Exposure to ionizing and non-ionizing radiation is possible. The contractor shall use appropriate safety procedures and devices, such as Lock Out-Tag Out, as required by the Government.

1.11. Physical Requirements. The nature of the work requires moderate physical effort. The biomedical equipment technician frequently is required to lift, carry or otherwise, handle, items weighing up to 18 kilograms (40 pounds) with occasional encounters involving items greater than 18 kilograms. Frequent standing, walking, bending, crouching, reaching, stooping and working in cramped and awkward positions for prolonged periods is required. In addition to health requirements in the contract, the individual must pass color vision test, not provided by the government.

1.12. A valid driver’s license is required for the position in order to obtain authorization to drive a Government motor vehicle to service medical equipment that may be located in other buildings.

2.0. CORE DUTIES

2.1. Test and calibrate components using manufacturers' manuals and troubleshooting techniques, hand tools, power tools and measuring devices.

2.2. Keep records of maintenance, repair, and required updates of equipment.

2.3. Inspect and test malfunctioning medical and related equipment following manufacturers' specifications, using test and analysis instruments.

2.4. Disassemble malfunctioning equipment and remove, repair and replace defective parts such as motors, transformers, and circuit boards.

2.5. Perform preventive maintenance or service such as cleaning, lubricating and adjusting equipment in accordance with OEM specifications.

2.6. Test, evaluate, and classify excess or in-use medical equipment and determine serviceability, condition, and recommend disposition in accordance with Air Force Instructions.

2.7. Examine medical equipment and facility's structural environment and check for proper use of equipment, to protect patients and staff from electrical or mechanical hazards. Ensure compliance with safety regulations and policies.

2.8. Study technical manuals and attend on-site training sessions provided by equipment manufacturers to maintain current knowledge.

2.9. Provide training to medical staff by explaining and demonstrating correct operation and operator preventive maintenance of medical equipment.

2.10. SUMMARY. Install, inspect, repair, calibrate, and modify biomedical equipment and support systems.

Advise staff and other agencies on operation theory, underlying physiological principles, and safe clinical application of biomedical equipment. Provide technology management and equipment repair/calibration support for the medical treatment facility. Assess and evaluate the condition of in-use medical equipment for maintenance, upgrade, or replace recommendations.

CERTIFIED MEDICAL TECHNICIAN (ASSISTANT) – OUTPATIENT

1.1. Completion of a medical assistance program recognized and accredited by the Commission on Accreditation of

Allied Health Education Programs (CAAHEP) or the Accrediting Bureau of Health Education Schools (ABHES), or, equivalent combinations of successfully completed post-high school education and experience (i.e. military training).

1.2. Completion of high school with courses in general science, biology, psychology, and chemistry.

1.3. At least 12 months of experience within the last 36 months, in an outpatient clinic setting. Experience performing nursing activities in the care and treatment of patients; operating and maintaining therapeutic equipment;

conducting sub-professional portions of physical examinations; or assisting in medical treatment of patients.

1.4. Mandatory Knowledge. Medical terminology, anatomy and physiology; nursing theory, techniques and procedures; team nursing; patient needs; emergency medical treatment to include cardiopulmonary resuscitation, aseptic technique, medical ethics, and legal aspects; prescription drugs and their administration; operating and maintaining therapeutic equipment, risk management, contingency operations, disaster preparedness, chemical warfare; and transportation of sick and wounded. Vaccination procedures; methods of properly administering intradermal, subcutaneous, and intramuscular injections; allergen identification; composition of various vaccines;

mechanisms of anaphylaxis and shock and their treatment; and pharmacology of various drug groups.

2.1. Serve as a medical assistant performing patient care and nursing administrative duties for outpatients in accordance with established policies, procedures, protocols, and guidelines.

2.2. Monitor and record physiological measurements.

2.3. Orient new patients to the clinic environment.

2.4. Prepare and position patients for examinations and treatments.

2.5. Prepare and administer medications under nurse or physician supervision.

2.6. Frontline preventionist, identify potential health risks and provide preventive counseling.

2.7. Perform paraprofessional portions of preventive health assessments and physical examinations.

2.8. Perform medical records reviews in order to determine medical needs.

2.9. Establish and maintain good interpersonal relationships with military treatment facility patients and staff.

2.10. Perform portions of medical treatment, diagnostic, and therapeutic procedures in accordance with established policies, procedures, and protocols. Record treatment and procedure rendered, and observe effects. Identify patient problems and accurately notifies nursing team.

2.11. Adhere to infection control procedures including the use of personal protective equipment, disposal of waste, and aseptic technique.

2.12. Perform central sterile supply duties.

2.13. Ensure all equipment is properly cleaned and stored at the end of each work shift. Ensure preventive maintenance and routine cleaning are performed as directed.

2.14. Perform basic life support and triage in emergency situations.

2.15. Perform paraprofessional portions of preventive health assessments and physical examinations when required.

2.16. Maintain outpatient medical records. Prepare and submit administrative reports.

2.17. Participate in in-service training and continuing education programs for new procedures, techniques, and equipment.

2.18. Schedule/attend in-service training in new procedures, techniques, and equipment. Conduct or schedule periodic disaster training, fire drills, and evacuation procedures. Provide medical training to include agencies and personnel other than medical.

2.19. Provide required basic life support training.

2.20. Ensure a safe work environment and employee safe work habits.

2.21. Other related duties assigned.

2.22. Summary: Assist in the routing patient care and treatment of beneficiaries, to include flying and special operational duty personnel, when required. Organize the medical environment, perform and direct support activities for outpatient care situations, including contingency operations and disasters.

CHIROPRACTIC TECHNICIAN

1.1. High school diploma or GED required.

1.2. Possess basic clinical knowledge in anatomy and physiology, patient care and treatment procedures, preventive health medicine, infection control concepts, medical terminology, medical forms and records management, guidelines for release of medical information (Privacy Act of 1974), medical and legal ethics, supply procedures, information systems and medical evaluation information.

1.3. At least 12 months of experience within the last 24 months performing chiropractic treatments in a Chiropractic clinic under the supervision of a Doctor of Chiropractic.

1.4. Possess and maintain current certification in Basic Life Support (BLS)

1.5. Proficiency in operating word processing computer operations, performing general data entry functions, and the ability to utilize the Government electronic medical record system, Armed Forces Health Longitudinal Technological Application (AHLTA) and/or any other military patient management system.

1.6. Read, understand, speak and write English fluently.

2.0. CORE DUTIES

2.1. Work under the general supervision of a Doctor of Chiropractic and provide chiropractic treatments/procedures in the clinic in a safe and medically accepted manner as directed by the Doctor of Chiropractic.

2.2. Initiate intake of new patients into clinic by taking and recording vital signs, assembling a new patient record with all appropriate forms, and assisting patients in completion of questionnaires and other documentation as requested.

2.3. Provide chiropractic treatments/procedures to include ultrasound, electrical stimulation, vibratory massage, heat, cold, diathermy, transverse friction massage, trigger point therapy and cervical and lumbar mechanical traction.

These chiropractic services will be performed for active duty service members only.

2.4. Document chiropractic treatments in patient record and initial record. Report any unusual reaction to treatment immediately to the chiropractor.

2.5. Instruct patients regarding nutrition, ergonomics, proper posture, stretches and exercises, and locations of further testing/procedures.

2.6. Supervise patient exercise programs as necessary.

2.7. Keep the chiropractor appraised of patient progress and any changes in health status.

2.8. Immediately report hazardous or malfunctioning equipment to the chiropractor.

2.9. Ensure adequate supply of hot packs, ice packs, towels, ultrasound gel, proper levels of water in hydro collator, table paper, brochures, etc. in treatment room and sufficient quantities in reserve in stockroom. Provide information to supply custodian as necessary to maintain prescribed quantities.

2.10. Verify, maintain and clean equipment. Monitor cleanliness and proper functioning of all equipment and report any malfunctioning to the chiropractor. Provide information to the equipment custodian to generate work orders as necessary.

2.11. Exchange linen daily, and store clean, folded linen in designated areas.

2.12. Attend clinic or hospital in-services and required training and meetings.

2.13. Assist with clinic administrative activities when assigned.

2.14. Coordinate and communicate with other clinic staff (medical physicians, nurses, physical therapists, and technicians) to ensure patients receive excellent care in a timely manner.

2.15. Ensure reception area is manned by arranging breaks and other clinic duties accordingly.

2.16. Escort patients to treatment rooms and coordinate patient flow to ensure patients are not waiting for appointments or instructions.

2.17. Manage clinic appointment schedule.

2.18. Answer telephone and direct patient inquiries appropriately.

2.19. Request medical records, x-rays, and test results from appropriate clinic departments.

2.20. Maintain documentation regarding records requests, records releases, supplies ordered, and new patients scheduled.

2.21. Ensure adequate amount of office supplies. Provide information to supply custodian as necessary to maintain needed quantities.

2.22. Assure cleanliness of reception area, treatment rooms, and physician offices via regularly scheduled cleaning assignments, and as necessary.

CHIROPRACTOR

1.1. Hold a current, unrestricted license to practice as a Doctor of Chiropractic in any one of the fifty States, the District of Columbia, the Commonwealth of Puerto Rico, Guam or the U.S. Virgin Islands. License cannot be under investigation nor have any adverse action pending from a State Board or national licensing/certification agency.

1.2. Possess a degree from a chiropractic college accredited by the Council on Chiropractic Education.

1.3. Experience as a chiropractor, licensed independent practitioner for at least 24 months within the last 36 months for both diagnostic and treatment services.

2.0. CORE DUTIES

2.1. Perform standard osseous and soft tissue procedures only, as commonly taught in Chiropractic College accredited by the Council on Chiropractic Education.

2.2. Delivery of treatment within the personnel and equipment capabilities of the Military Treatment Facility (MTF), provision of mandated medical surveillance and preventive services and the quality and timeliness of treatment records and reports required to document procedures performed and care provided.

2.3. Employ and record every measure of observation that will more substantially profile the patient during the initial patient interview and consultation.

2.4. Conduct a patient history and chiropractic physical examination (excluding vaginal examination) as clinically indicated.

2.5. Utilize X-ray and standard laboratory tests appropriate to the chiropractic diagnosis and within the MTFs capabilities as detailed by the standard MTF operating procedures. Radiological examinations shall be limited to musculo-skeletal radiographs, skull series, chest (PA and lateral views) and rib series. MRI and CT studies of the spine and Bone Scans may be ordered following protocols established by the department of orthopedics. Lab tests shall be limited to SMA6, UA/C&S, Occult Blood, Erythrocyte Sedimentation Rate and Complete Blood Count.

2.6. Utilize the modalities of heat, cold, light, electricity, sound and exercises in patient treatment area.

2.7. Provide patient instructions and recommendations in all matters pertaining to hygiene, nutrition, exercise and life style changes and ergonomic factors in the activities of daily living.

2.8. Refer patients to specialty services available at the MTF.

2.9. Orient, instruct, direct, and evaluate work activities of clinical support staff.

2.10. Plan and conduct lectures and training programs on chiropractic related subjects for staff, students, and patients. Teach, conduct or participate in seminars concerning the basic and/or clinical sciences of chiropractic if requested by the Government.

2.11. Order orthotics, lifts, collars, and lumbar sacral supports if available at the MTF.

2.12. Place active duty patients on limited duty status (profile) according to MTF bylaws.

2.13. Document in the appropriate electronic health record (i.e. AHLTA, MHS Genesis, or other similar electronic system required by the government/MTF), and/or on forms provided by the MTF, all discussions and actions taken during the patient visit, including but not limited to patient history/subjective exam, evaluation/objective exam, diagnosis/assessment, prognosis, treatments/adjustments performed, patient response to treatments, and treatment plan in accordance with the standard MTF operating procedures and Chiropractic specialty peer review requirements.

2.14. Participate in weekly meetings to review and evaluate the care provided to patients, identify opportunities to improve the care delivered, and recommend corrective action when problems exist.

2.15. Attend annual renewal of the following Annual Training Requirements: family advocacy, disaster training, sexual harassment, and other courses as directed.

2.16. Utilize Government computer systems technology for data input and retrieval (e.g. orders, lab results).

2.17. Other related duties as assigned.

2.18. Perform chiropractic services available under the contract for active duty service members only.

CLINICAL NURSE-BEHAVIORAL HEALTH

1.1. Be a graduate from a baccalaureate (BSN) degree program in nursing accredited by a national nursing accrediting agency recognized by the US Department of Education.

1.2. License/certification. Maintain an active, valid, current, and unrestricted license (with no limitations, stipulations or pending adverse actions) to practice nursing as a registered nurse in any US state/jurisdiction.

License cannot be under investigation nor have any adverse action pending from a State Board or national licensing/certification agency.

1.3. A minimum of 2 years’ experience for BSN in mental health nursing and practiced in a mental health setting within the last 12 months.

1.4. Certified/certification eligible by the American Nurses Credentialing Center (ANCC) as a Psychiatric and

Mental Health Nurse with 2 years full time experience in mental health.

1.5. Possess and maintain a current certification in Basic Life Support (BLS). Advanced Cardiac Life Support

(ACLS) is highly recommended.

1.6. Ability to effectively apply the following core case management functions:

a) Assessment and identification of patients for case management and need for an established plan of care.

b) Collaboration with the patient, family/caregiver, and members of the health care team for developing an effective plan of care.

c) Facilitation of care coordination and communication among all involved parties.

d) Advocate for the patient and family/caregivers to ensure identified education and appropriate, timely care is received.

1.7. Ability to effectively apply the following core disease management principles to mental health conditions:

a) Assessment and identification of target populations.

b) Implementation and execution of clinical practice guidelines or standards.

c) Collaboration and coordination of activities with other healthcare members.

d) Promotion and education of patient self-management actions.

e) Collection, analysis and reporting on identified process and outcome metrics.

1.8. Knowledge of medical privacy and confidentiality (Health Insurance Portability and Accountability Act

(HIPAA)), and accreditation standards of Accreditation Association for Ambulatory Health Care (AAAHC) and The

Joint Commission (TJC).

1.9. Working knowledge of computer applications/software to include Microsoft Office programs, MS Outlook (e-mail) and Excel.

1.10. Skillful and tactful in communicating with people who may be physically or mentally ill, uncooperative, fearful, emotionally distraught, and occasionally dangerous.

1.11. Demonstrated ability to apply critical thinking skills and expertise in resolving complicated healthcare, social, interpersonal and financial patient situations.

1.12. Possess organization, problem-solving and communication skills to articulate medical requirements to patients, families/care givers, medical and non-medical staff in a professional and courteous way.

1.13. Physical Requirements. Requirements include some walking, standing, extended periods of sitting. May require pushing, pulling, bending and lifting in emergency situations requiring basic life support procedures.

Position may have exposure to communicable illnesses.

1.14. Position may require travel for Behavioral Health Consultant training in Bethesda/Silver Spring Maryland.

1.15. Must have a mature command of speaking, writing and reading in the English language.

2.1. Proactively identify and evaluate patients and targeted populations for mental health case management, care coordination and facilitation, and conditions monitoring from a variety of sources such as Behavioral Health or primary care provider referrals, discharge planning, Medical Evaluation Board (MEB) process, facility staff and patient self-referral.

2.2. Conduct systematic, on-going, thorough assessment of patient's emotional, psychological, social and medical status, prescribed medications, behavioral health referrals/treatments, and other pertinent information via direct patient or telephonic contact, or other relevant sources such as professional and non-professional caregivers and the medical records.

2.3. Develop, execute and provide ongoing monitoring of appropriate patient-specific plan of care including short and long term goals, objectives and actions. Coordinate and collaborate on the care plan along with the patient, family/caregiver, and healthcare team.

2.4. Identify, develop and execute appropriate targeted population-based mental health disease management activities such as, but not limited to, individual and/or group patient contacts and training programs.

2.5. Serve as an advocate for and ensure appropriate education is provided to the patient or targeted populations for the purpose of promoting adherence to treatment plans, self-care actions, and education programs. Ensure activities match the level of the patient's clinical risk, readiness to change, and health literacy.

2.6. Identify, collect, monitor, interpret and evaluate measureable outcome data within established time frames according to local/Air Force/Department of Defense requirements. Submit reports as required per local/Air

Force/Department of Defense policy and guidance.

2.7. Educate/train the healthcare team and facility staff on policies and procedures for utilization and implementation of guidelines, protocols, and other behavioral health and mental health disease management activities.

2.8. Coordinate and participate in interdisciplinary team meetings, designated facility meetings, and care coordination meetings. Share knowledge and experiences gained from own clinical nursing practice and education relevant to mental health nursing and case management. Participate in local/Air Force/Department of Defense and national teleconferences as required and relative to the program operations and reporting requirements.

2.9. Participate in the orientation, peer review, education and training of other staff. May serve on committees, work groups, and task forces at the facility.

2.10. Maintain a level of productivity and quality consistent with: complexity of the assignment; facility policies and guidelines; established principles, ethics, standards, and scope of practice for professional mental health nursing as outlined by the American Nurses Association and the American Psychiatric Nurses Association; the American

Hospital Association's Bill of Rights for Patients, the Case Management Society of America(CMSA), American

Accreditation Healthcare Commission/Utilization Review Accreditation Commission (URAC); The Joint

Commission (TJC); Unit Effectiveness Inspection (UEI); and other applicable Department of Defense and Service specific guidance and policies. Must also comply with the Equal Employment Opportunity (EEO) Program, infection control and safety policies and procedures.

2.11. Follow applicable local Military Treatment Facility/Air Force/Department of Defense instructions, policies and guidelines.

2.12. Complete electronic medical record documentation, coding and designated tracking logs and data reporting as required by local Military Treatment Facility/Air Force/Department of Defense instructions, policies and guidance.

2.13. Complete all required electronic medical record training, MTF-specific orientation and training programs, and

Air Force/Department of Defense mandated training applicable to the job.

2.14. Has a thorough understanding of psychopharmacology and psychotropic medications, administers medications and monitors patient response to medication.

2.15. Summary. As a member of the Behavioral Health team, provide mental health clinical case management, care coordination and disease management. This includes, but not limited to, the conditions of depression, anxiety disorders, tobacco cessation, weight management, Traumatic Brain Injury (TBI) and Post Traumatic Stress Disorder

(PTSD). Monitor and facilitate adherence to treatments, provide education, coordinate care, and maintain data registries, perform full scope of clinical nursing in the execution of outpatient mental health care.

CLINICAL NURSE – FAMILY PRACTICE

1.0. QUALIFICATIONS

1.1. A permanent, full, and unrestricted license to practice as a Registered Nurse in the location of the 355th Medical Group (355 MDG) and must meet credentialing/accreditation requirements of the 355 MDG, the US Air Force, and the Defense Health Agency (DHA). License cannot be under investigation nor have any adverse action pending from a State Board or national licensing/certification agency.

1.2. A minimum of 24 months of nursing experience within the last 36 months. Experience in a primary care setting with at least 12 months of family practice experience is highly desirable.

1.3. Possess and maintain current certification in Basic Life Support (BLS). Advanced Cardiac Life Support (ACLS) and Pediatric Life Support (PALS) is highly encouraged.

1.4. National certification in Ambulatory Care Nursing is highly desirable.

1.5. A mature command of speaking, writing, and reading the English language.

1.6. A strong working knowledge and skills to use a variety of computer systems. A strong working knowledge of the military health care system and computer documentation is highly desirable.

1.7. A strong working knowledge of the military health care system including TRICARE health benefits, fee-for service principles, preferred provider network and managed care/HMO organizations is highly desirable.

2.0. CORE DUTIES.

2.1. Provide comprehensive professional nursing care for TRICARE Prime enrolled beneficiaries, as well as TRICARE for Life and space available beneficiaries ranging from newborn to geriatric age presenting with complex and interdependent acute and chronic conditions.

2.2. Serve as a part of the Primary Care Manager (PCM) team within the Air Force Medical Home (AFMH) model of health care delivery, providing nursing assistance in the full spectrum management of professional and patient care activities within their scope of practice.

2.3. Assess and identify individual patient care needs, applying the nursing processes and protocols in making appropriate clinical decisions for pediatric, adolescent, adult, obstetric, and geriatric patients in a cost-effective manner.

2.4. Execute medical orders, request diagnostic tests, and place appropriate referrals per local guidance and/or as directed by a provider.

2.5. Assist in obtaining diagnostic test results and outside consultations, notifying the provider of abnormal results, and…