Community Care Case Manager

Summary

This position is eligible for the Education Debt Reduction Program (EDRP) - a student loan payment reimbursement program. You must meet specific eligibility requirements per VHA policy and submit your application within four months of appointment. Program Approval - award amount (up to $200 -000) & eligibility period (one to five years) are determined by the VHA Education Loan Repayment Services program office after review of the EDRP application. Former EDRP participants ineligible to apply.

Qualifications

Basic Requirements:

• English Language Proficiency
• In accordance with 38 U.S.C. 7403(f) - no person shall serve in direct patient care positions unless they are proficient in basic written and spoken English
• Graduate of a school of professional nursing approved by the appropriate accrediting agency and accredited by one of the following accrediting bodies at the time the program was completed by the applicant: The Accreditation Commission for Education in Nursing (ACEN) or The Commission on Collegiate Nursing Education (CCNE)
• OR Individuals attending a master's level bridge program in nursing who have completed coursework equivalent to a bachelor's level degree in Nursing may have opportunity to become registered as a nurse with a state licensing board prior to completion of the bridge program
• Upon achievement of a State license - the individual may be appointed on temporary basis and later converted to a permanent appointment upon successful completion and graduation from the bridge program
• (Reference VA Handbook 5005 - Appendix G6)
• OR In cases of graduates of foreign schools of professional nursing - possession of a current - full - active - and unrestricted registration will meet the requirement for graduation from an approved school of professional nursing to warrant an appointment as a Nurse who has completed an associated degree/entry level Nursing education program
• Credit for foreign nursing education higher that associate degree/entry level requires a formal degree equivalency validation from a recognized equivalency evaluation accepted by VA such as International Consultants of Delaware (ICD)
• Current - full - active - and unrestricted registration as a graduate professional nurse in a State - Territory or Commonwealth (i.e. - Puerto Rico) of the United States - or the District of Columbia
• Graduate Nurse Technician (GNT) Exception: Candidates who otherwise meet the basic education requirements - but do not possess the required licensure - may be appointed at the entry step of the grade and level applicable to the completed nursing education as a GNT on a 120-day temporary appointment while actively pursuing licensure (may be extended up to two years on a case-by-case-basis.) NOTE: Grandfathering Provision - All persons currently employed in VHA in 0610 series and performing the duties as described in the qualification standard on the effective date of the standard (1/29/2024) are considered to have met all qualification requirements for the grade held including positive education and licensure/certification
• Grade Determinations: The following Scope - Education and Dimension criteria must be met in determining the grade assignment of candidates - and if appropriate - the level within a grade
• The Dimension requirements (Practice - Veteran/Patient Driven Care - Leadership - Professional Development and Evidence-Based Practice/Research) are detailed for each grade and level within the online assessment:
• Grade/Level Scope Education Nurse I - Level I Delivers fundamental - knowledge-based care to assigned clients while developing technical competencies
• An Associate Degree (ADN) or Diploma in Nursing - with no additional professional nursing required
• Nurse I - Level II Demonstrates integration of biopsychosocial concepts - cognitive skills and technically competent practice in providing care to clients with basic or complex
• An ADN or Diploma in Nursing AND 1 year of specialized nursing experience equivalent to Nurse I - Level 1 ;OR a Bachelor of Science in Nursing (BSN) with no additional professional nursing experience required
• Nurse I - Level III Demonstrates proficiency in practice based on conscious and deliberate planning
• Self-directed in goal setting for managing complex client situations
• An ADN or Diploma in Nursing AND 2 years of professional nursing experience in which one year is equivalent to Nurse I - Level 2
• OR a BSN and 1 year of professional nursing experience equivalent to the Nurse I - Level 2
• OR a Master's degree in nursing (MSN) and no additional professional nursing experience
• OR a Master's degree in a *related field with a BSN and no additional professional nursing experience
• Nurse II Demonstrates leadership in delivering and improving holistic care through collaborative strategies with others
• A BSN with 2 years of professional nursing equivalent to Nurse I - Level 3
• OR an MSN with one year of specialized nursing experience equivalent to Nurse I - Level 3
• OR a Master's degree in a *related field with a BSN and one year of specialized nursing experience equivalent to Nurse I - Level 3
• OR a Doctoral degree in Nursing with no professional nursing experience
• OR a Doctoral degree in a *related field with a BSN with no additional professional nursing experience
• Nurse III Executes position responsibilities that demonstrate leadership - experience and creative approaches to management of complex client care beyond the immediate practice setting
• MSN and 2 years of specialized nursing experience - one of which is equivalent to Nurse II and meets all dimension requirements for Nurse III
• OR a Master's degree in *related field with BSN and two years of specialized nursing experience - one of which is equivalent to Nurse II and meets all dimension requirements for Nurse III
• OR a Doctoral degree in Nursing with and one year of specialized nursing experience equivalent to Nurse II and meets all dimension requirements for Nurse III
• OR a Doctoral degree in a *related field with a BSN and one year of specialized nursing experience equivalent to Nurse II and meets all dimension requirements for Nurse III
• *Note: Foreign education programs/degrees are not creditable as related degrees
• Preferred Experience: Community Care experience Reference: For more information on this qualification standard - please visit
• Physical Requirements: This position requires - use of fingers - hands and legs - walking - bending and able to hear whisper
• The incumbent must be physically - emotionally and mentally stable in order to efficiently perform the essential functions of this position without hazard to themselves or others.

Duties

• The Case Management (CM) Registered Nurse (RN) executes position responsibilities that demonstrate leadership - experience - and creative approaches in providing complex patient management
• The Community Care CM RN demonstrates knowledge and use of general business rules outlined in VHA Notice 2024-01 - Purchased Home and Community Based Services Programs - VHA Directive 1230 Outpatient Scheduling Management - VHA Directive 1232(5) - Consult Processes and Procedures and VHA Notice 2019-09(2) - Minimum Scheduling Effort Requested for Outpatient Appointment and Office of Integrated Veteran Care (IVC) Community Care Field Guidebook
• Provides patient management - care coordination - and discharge/disposition planning for community hospital inpatients and community outpatient settings if the outpatient care is authorized via community care
• The Community Care CM RN is responsible for executing a streamlined approach to receiving and triaging within two days and directing timely coordinated care for Skilled Home Health Care (SHHC) and Community Care inpatient/emergency consults
• The Community Care CM RN will assess a a Veteran's care coordination needs utilizing the Screening Triage (S/T) tool within the Consult Toolbox (CTB)
• The S/T Tool will provide a care coordination level (basic - moderate - complex/ chronic - or ugent) with recommended care coordination activities for the Veteran
• The S/T Tool utilmatley assigned the Veteran to one of four coordination levels - which are reflective of the intensity - frequency - duration and care coordination services required
• The Community Care CM RN will perform clinical review of the medical record to select the appropriate Standardized Epidose of Care (SEOC) based on the order/ referral for the clinically appropriate SEOC that outlines allowable services related to a specialty or sub-specialty within two days
• The Community Care CM RN will work 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 The Community Care CM RN assists Veterans - family members - and caregivers with receiving the most appropriate options and services to meet their complex health care needs
• This includes - but is not limited to - acute - chronic - multiple - complex - catastrophic - or lifethreatening illnesses
• combat stress - residuals of traumatic brain injury
• community adjustment
• addictions and other health problems
• Coordinates care with multiple providers across all levels and sites of care
• The Community Care CM RN addresses psychosocial - as well as nursing and medical needs of patients and their families/caregivers - through participation in interdisciplinary patient care management practice
• VA offers a comprehensive total rewards package: VA Nurse Total Rewards 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 7:30am - 4:00pm or 8:00am to 4:30pm Telework: Not Available Virtual: This is not a virtual position
• Relocation/Recruitment Incentives: EDRP Authorized: This position is with the Access & Office of Community Care (AOCC) Service line.Former EDRP participants ineligible to apply for incentive
• Contact [email protected] - the EDRP Coordinator for questions/assistance
• Learn more

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The Veterans Health Administration (VHA) is the largest integrated health care system in the United States, providing care at 1,321 health care facilities, including 172 VA Medical Centers and 1,138 outpatient sites of care of varying complexity (VHA outpatient clinics) to over 9 million Veterans enrolled in the VA health care program. VHA Medical Centers provide a wide range of services including traditional hospital-based services such as surgery, critical care, mental health, orthopedics, pharmacy, radiology and physical therapy. In addition, most of our medical centers offer additional medical and surgical specialty services including audiology & speech pathology, dermatology, dental, geriatrics, neurology, oncology, podiatry, prosthetics, urology, and vision care. Some medical centers also offer advanced services such as organ transplants and plastic surgery.

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