Nurse Practitioner (HSA 5.3 CSP Centralized Eligibility and Appeals Team)

Job Title

This is not a remote position and the selected VHA employee must be located (or willing to relocate) within 50 miles of a VA Facility within the HSA 5.3 (Legacy VISN 22) catchment area and have space available for assignment--Albuquerque, Greater Los Angeles, Loma Linda, Long Beach, Prescott, San Diego.

Duties

Duties include, but are not limited to:

• Supporting the mission, policies, and procedures of the Department of Veterans Affairs, the Veterans Health Administration (VHA), the appropriate Veterans Integrated Service Network (VISN), and its associated facilities.
• Conducting comprehensive record reviews for the purposes of determining PCAFC eligibility, level of care, and appropriateness for participation per statue, regulation, policy, and guidelines. This is done from a Nurse Practitioner's perspective.
• Sustaining expert knowledge of eligibility criteria for the PCAFC and the regulations, statutes, directives and policies that govern or impact the program and decision making.
• Bringing a knowledge of, and ability to interpret the widest array of applicable assessments, tests, and medical records to assist CEAT with case disposition.
• Disability claim review and decision-making, resulting in forensic-style clinical letter writing in compliance with all applicable federal laws, VA regulations, and professional practice standards. This requires substantial independent clinical judgment, in-depth knowledge of complex case presentations, and the ability to expeditiously synthesize medical, psychosocial, and functional information for benefits determinations.
• Participation in inter-professional decision-making teams regarding clinical eligibility and appropriate level of caregiving required.
• Sensitivity to the issues and needs of Veterans and their families, when rendering clinical eligibility determinations.
• Conducting Peer Reviews from a Nurse Practitioner standpoint, which may occur at the regional level, to aide in achieving consistency nationally.
• Using professional standards of care, scientific evidence, and practice to evaluate program and/or service activities and implementing broad-reaching evidence-based change.
• Coordinating with VISN CEAT, other Regional CEATs and VACO CSP to develop and implement strategies for PCAFC determinations, appeals process, and performance improvement.
• Demonstrating knowledge and skill in the use of software applications for drafting documents and data management as well as other computer systems in use by the VHA to track workload and outcomes.
• Maintaining a level of productivity and quality consistent with the complexity of the assignment and consistent with Nurse Practitioner, Joint Commission, Program Office and VISN standards.
• Maintaining advanced knowledge and understanding of both the services and benefits available for caregivers from both federal, state and private sector resources.
• Evaluating program progress and outcomes and utilizes data to continuously modify and improve the program and processes.
• Completing all requested reports, data, and maintain reporting requirements with outcomes related to the CSP.
• Ability to coordinate patient care through patient management techniques across the patient care continuum.
• Effectiveness in recognizing emergency/acute situations and intervening in an appropriate and effective manner.
• Keeping supervisor apprised of problems and recommended solutions to problems encountered in the incumbent's area of responsibility.
• Furthering one's own professional growth through continuing education and for ensuring continuing education appropriate to the area of assignment.
• Actively participating in the CSP conference calls and participating in other relevant conference calls and/or meetings as assigned.

Total Rewards Package

VA offers a comprehensive total rewards package:

• Pay: Competitive salary, regular salary increases, potential for performance awards
• Paid Time Off: 50 days of paid time off per year (26 days of annual leave, 13 days of sick leave, 11 paid Federal holidays per year)
• Retirement: Traditional federal pension (5 years vesting) and federal 401K with up to 5% in contributions by VA
• Insurance: Federal health/vision/dental/term life/long-term care (many federal insurance programs can be carried into retirement)
• Licensure: 1 full and unrestricted license from any US State or territory
• Work Schedule: Monday - Friday, 8am - 4:30pm PST; Hours are TBD based on the needs of the Service or Agency
• Compressed/Flexible Schedule: May be Available
• Telework: Ad-Hoc only
• Remote: This is not a remote position.
• Relocation/Recruitment Incentives: Not Authorized
• Permanent Change of Station (PCS): Not Authorized