Nurse - Community Care Coordinator

Community Care Coordinator Registered Nurse (RN)

Duties include, but are not limited to:

• Executing a streamlined approach to receiving, triaging, and directing timely, coordinated care.
• Demonstrating proficient practice and decision-making, deliberate planning, and critical thinking skills.
• Possessing intimate knowledge of the internal referral care process, clinical review criteria, utilization management standards, clinical documentation requirements, community care regulations, and Veterans Health Administration (VHA) standards and guidelines.
• Using nursing knowledge and systems theory to assess, organize, facilitate, and guide Veterans through their full range of care options including internal/direct care in Veterans Affairs (VA) and care in the community.
• Serving as a liaison to both internal and community providers and managing the care of the Veteran throughout the consult process.
• Supporting the medical center's mission to improve timely access to care, ensure Veterans who want to receive care in the community are referred and scheduled into the community, and support the delivery of high quality, timely care to the Veteran receiving community services.
• Working collaboratively within the Office of Integrated Veteran Care (IVC) to triage Request for Services (RFS) to coordinate care processes defined by the IVC Field Guidebook to include developing a care coordination plan, reviewing medical documentation from community providers, communication of care coordination needs, and supporting the Veteran through the completion of the episode of care.
• Influencing care outcomes by collaborating with members of the interdisciplinary team both within the Veterans Affairs (VA) and in the community.
• Complying with VA-mandated processes and use of health information solutions that serve to assess, document, exchange, and track care coordination information.
• Utilizing delegation of authority, if applicable, to function at their highest level of role performance and align high-quality care with key performance indicators to ensure practice standards meet patient care needs.
• Supporting colleagues and other nurses through knowledge sharing to provide safe, quality nursing care.
• Fostering a safe and supportive environment conducive to the professional development of health care professionals.
• Evaluating outcomes of evidence-based decisions and practice changes for individuals, groups, and populations.
• Being responsible for the documented outcomes at the program or service level. Program or service level outcomes must be broad and complex and can be demonstrated at any organizational level within facility/VISN level.
• When appropriate, Co Coordinators will be expected to assume the responsibility of a Care Coordination and Integrated Case Management (CCICM) Lead Coordinator serving as the primary point of contact for Veterans who require moderate to complex care coordination, oversee, and facilitate integrated care across VA service lines, healthcare settings, and treatment episodes ensuring seamless and comprehensive care is provided.
• Other duties as assigned.

Preferred Experience: ER, ICU, Surgery, Case Management, Med-Surg

VA offers a comprehensive total rewards package:

• Competitive salary, regular salary increases, potential for performance awards
• 50 days of paid time off per year (26 days of annual leave, 13 days of sick leave, 11 paid Federal holidays per year)
• Traditional federal pension (5 years vesting) and federal 401K with up to 5% in contributions by VA
• Federal health/vision/dental/term life/long-term care (many federal insurance programs can be carried into retirement)
• 1 full and unrestricted license from any US State or territory

Work Schedule: Monday - Friday; 7:00 AM - 3:30 PM or 7:30 AM - 4:00 PM or 8:00 AM - 4:30 PM.

Telework: Not Available

Virtual: This is not a virtual position.

Relocation/Recruitment Incentives: Not Authorized

Permanent Change of Station (PCS): Not Authorized

US Department of Veterans Affairs