Community Care Clinical Review - Registered Nurse
The Community Care Clinical Review Nurse is a Registered Nurse with case management experience. The incumbent serves as a coordinator in a multi-disciplinary environment interacting with Primary Care Service, Medicine Service, Nursing Service, Surgery Service, Radiology, and community-based hospitals and providers which provide care for VA patients. An understanding of VA inpatient care, VA outpatient care, Ambulatory Surgery and Interventional Radiology procedures is necessary for successful completion of required duties. The incumbent must possess strong clinical skills and the ability to work independently. Incumbent has knowledge of computer technology and software application skills, specifically Microsoft Excel in order to develop effective data management. Incumbent has knowledge of regulatory standards and credentialing set forth by groups such as The Joint Commission and Office of Inspector General and works with a team to coordinate clinical review activities. The incumbent possesses knowledge of applicable rules and regulations, in particular as they relate to consult management and the MISSION Act. Incumbent works on multiple projects at the same time and prioritizes duties effectively while coordinating work with and soliciting the cooperation of other Services. Incumbent interacts effectively with individuals orally and through written communication, both formal and informal. The incumbent organizes and coordinates the work performed by others and provides follow up as necessary. The Community Care Clinical Review Nurse maintains excellent interpersonal relationships with staff, interdisciplinary colleagues, patients and their families/significant others, and Community Care providers and their staff. The Clinical Review Nurse is responsible for identifying, facilitating, and coordinating patient-centered care options and services between VA and authorized Community Care providers. The Clinical Review Nurse functions as a liaison and is responsible for planning, coordinating, and performing a wide range of case management, clinical, administrative, program, and technical functions to support quality services for veterans. The Clinical Review Nurse works to facilitate patient satisfaction, to reduce duplication of services or delay of care, and to monitor quality of care and services received. The Clinical Review Nurse is directly responsible to the Nurse Manager of Care in the Community. The Clinical Review Nurse is responsible and accountable for the provision for the delivery of quality community care to a culturally diverse, Veteran patient population. The functions of the Clinical Review Nurse include, but are not limited to:
1. Clinical Review:
Review of community care consults for appropriateness and approval Assist with consult coordination through Non-VA Care referrals to community providers. Tracking high risks consults for care coordination Case management of patients with high risk diagnosis Assist with obtaining medical records from NON-VA providers to promote a smooth transition for the Veteran between Non-VA and VA care. Actively look for opportunities to improve service delivery and provide feedback to management and team. Utilize and maintain tracking spreadsheets, systems and outcomes as required by VHA Directives and Handbooks. Timely notification of the Veteran and VA Provider of both normal and abnormal findings of diagnostic testing performed in the community. Understanding and responding to gender-specific screening/diagnostics test results and reports Pay schedule:
NG23 Work Schedule:
Monday thru Friday 08:
00am - 12:
00pm Financial Disclosure Report:
Not required Applicants pending the completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met. Basic Requirements:
United States Citizenship:
Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. English Language Proficiency. In accordance with 38 U.S.C. 7402(d), 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 State-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). In cases of graduates of foreign schools of professional nursing, possession of current, full, active and unrestricted registration will meet the requirement of graduation from an approved school of professional nursing. OR The completion of coursework equivalent to a nursing degree in a MSN Bridge Program that qualifies for professional nursing registration constitutes the completion of an approved course of study of professional nursing. Students should submit the certificate of professional nursing to sit for the NCLEX to the VA along with a copy of the MSN transcript. (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. 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. Preferred
Experience:
BSN/MSN Minimum of 3-5 years experience care management. Grade Determinations:
The following criteria must be met in determining the grade assignment of candidates, and if appropriate, the level within a grade:
Nurse I Level I - An Associate Degree (ADN) or Diploma in Nursing, with no additional nursing practice/experience required. Nurse I Level II - An ADN or Diploma in Nursing and approximately 1 year of nursing practice/experience; OR an ADN or Diploma in Nursing and a bachelor's degree in a related field with no additional nursing practice/experience; OR a Bachelor's of Science in Nursing (BSN) with no additional nursing practice/experience. Nurse I Level III - An ADN or Diploma in Nursing and approximately 2-3 years of nursing practice/experience; OR an ADN or Diploma in Nursing and a Bachelor's degree in a related field and approximately 1-2 years of nursing practice/experience; OR a BSN with approximately 1-2 years of nursing practice/experience; OR a Master's degree in nursing (MSN) or related field with a BSN and no additional nursing practice/experience. Nurse II - A BSN with approximately 2-3 years of nursing practice/experience; OR ADN or Diploma in Nursing and a Bachelor's degree in a related field and approximately 2-3 year's of nursing practice/experience; OR a Master's degree in nursing or related field with a BSN and approximately 1-2 year's of nursing practice/experience; OR a Doctoral degree in nursing or meets basic requirements for appointment and has doctoral degree in a related field with no additional nursing practice/experience required. Nurse III - Master's degree in nursing or related field with BSN and approximately 2-3 year's of nursing practice/experience; OR a Doctoral degree and approximately 2-3 year's of nursing practice/experience. Reference:
VA Regulations, specifically VA Handbook 5005, Part II, Appendix G-6 Nurse Qualification Standard. This can be found in the local Human Resources Office. Physical Requirements:
The population of male and female veterans served ranges from the adult, age 18, to the elderly adult, age 65 and over. Lexington VAMC is a major interdisciplinary teaching facility, serving medical, surgical, neurological, and psychiatric inpatients and outpatients. This position requires visual acuity, keen hearing, clear distinctive speech, and manual dexterity. The incumbent may occasionally be exposed to patients who are combative secondary to delirium, dementia, or psychiatric disorders. The incumbent must be mature, flexible, sensible individual capable of working effectively in stressful situations, able to shift priorities based on patient needs.
Estimated Salary: $20 to $28 per hour based on qualifications.
1. Clinical Review:
Review of community care consults for appropriateness and approval Assist with consult coordination through Non-VA Care referrals to community providers. Tracking high risks consults for care coordination Case management of patients with high risk diagnosis Assist with obtaining medical records from NON-VA providers to promote a smooth transition for the Veteran between Non-VA and VA care. Actively look for opportunities to improve service delivery and provide feedback to management and team. Utilize and maintain tracking spreadsheets, systems and outcomes as required by VHA Directives and Handbooks. Timely notification of the Veteran and VA Provider of both normal and abnormal findings of diagnostic testing performed in the community. Understanding and responding to gender-specific screening/diagnostics test results and reports Pay schedule:
NG23 Work Schedule:
Monday thru Friday 08:
00am - 12:
00pm Financial Disclosure Report:
Not required Applicants pending the completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met. Basic Requirements:
United States Citizenship:
Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. English Language Proficiency. In accordance with 38 U.S.C. 7402(d), 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 State-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). In cases of graduates of foreign schools of professional nursing, possession of current, full, active and unrestricted registration will meet the requirement of graduation from an approved school of professional nursing. OR The completion of coursework equivalent to a nursing degree in a MSN Bridge Program that qualifies for professional nursing registration constitutes the completion of an approved course of study of professional nursing. Students should submit the certificate of professional nursing to sit for the NCLEX to the VA along with a copy of the MSN transcript. (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. 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. Preferred
Experience:
BSN/MSN Minimum of 3-5 years experience care management. Grade Determinations:
The following criteria must be met in determining the grade assignment of candidates, and if appropriate, the level within a grade:
Nurse I Level I - An Associate Degree (ADN) or Diploma in Nursing, with no additional nursing practice/experience required. Nurse I Level II - An ADN or Diploma in Nursing and approximately 1 year of nursing practice/experience; OR an ADN or Diploma in Nursing and a bachelor's degree in a related field with no additional nursing practice/experience; OR a Bachelor's of Science in Nursing (BSN) with no additional nursing practice/experience. Nurse I Level III - An ADN or Diploma in Nursing and approximately 2-3 years of nursing practice/experience; OR an ADN or Diploma in Nursing and a Bachelor's degree in a related field and approximately 1-2 years of nursing practice/experience; OR a BSN with approximately 1-2 years of nursing practice/experience; OR a Master's degree in nursing (MSN) or related field with a BSN and no additional nursing practice/experience. Nurse II - A BSN with approximately 2-3 years of nursing practice/experience; OR ADN or Diploma in Nursing and a Bachelor's degree in a related field and approximately 2-3 year's of nursing practice/experience; OR a Master's degree in nursing or related field with a BSN and approximately 1-2 year's of nursing practice/experience; OR a Doctoral degree in nursing or meets basic requirements for appointment and has doctoral degree in a related field with no additional nursing practice/experience required. Nurse III - Master's degree in nursing or related field with BSN and approximately 2-3 year's of nursing practice/experience; OR a Doctoral degree and approximately 2-3 year's of nursing practice/experience. Reference:
VA Regulations, specifically VA Handbook 5005, Part II, Appendix G-6 Nurse Qualification Standard. This can be found in the local Human Resources Office. Physical Requirements:
The population of male and female veterans served ranges from the adult, age 18, to the elderly adult, age 65 and over. Lexington VAMC is a major interdisciplinary teaching facility, serving medical, surgical, neurological, and psychiatric inpatients and outpatients. This position requires visual acuity, keen hearing, clear distinctive speech, and manual dexterity. The incumbent may occasionally be exposed to patients who are combative secondary to delirium, dementia, or psychiatric disorders. The incumbent must be mature, flexible, sensible individual capable of working effectively in stressful situations, able to shift priorities based on patient needs.
- Department:
0610 Nurse - Salary Range:
$50,863 to $100,241 per year
Estimated Salary: $20 to $28 per hour based on qualifications.
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