Registered Nurse (Home and Community Based Care)/Outpatient

Veterans Health Administration • Salisbury, NC

2d • Onsite

About The Position

The Registered Nurse (Home and Community Based Care)/Outpatient provides patient management, care coordination, and discharge/disposition planning for inpatient and outpatient settings. The Registered Nurse (RN), Home and Community Based Care (HCBC)/Outpatient is responsible and accountable for all elements of the nursing process when providing and/or supervising direct patient care. Assesses, plans, implements, and evaluates care based on age-specific components. Responsible for the coordination of care focused on patient education, self-management, and customer satisfaction throughout the continuum of care. The RN (HCBC) is responsible for providing competent, evidence-based care to assigned patients. 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 life-threatening 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. Coordination includes assuring services interface within the Veterans Affairs (VA) and HCBC programs to provide continuity of care to patients. Performs clinical nursing review of medical records of patients who are hospitalized in non-VA hospitals to determine point of stability for payment purposes and potential for transfer of the Veteran to a VA facility for care. Demonstrates knowledge of utilization management processes, clinical documentation requirements, current standards of care, and compliance guidelines. Maximizes third-party payments for care and delivering quality patient care improvement activities. Develops and coordinates transitioning of patients throughout the inpatient and outpatient care process with a focus on discharge planning needs. Reviews and assists in patient referrals to HCBC facilities to ensure continuity of qualified comprehensive care. Participates in the discharge planning assessment and implementation of community health services, to include skilled nursing care, hospice, adult day health services, respite services and activities required to successful transition the patient to the appropriate non-acute care setting. Performs follow-up and oversight visits to the Veteran after admission to HCBC to ensure that adequate and safe care is being provided while under VA contract. Performs other related duties as listed in functional statement.

Requirements

• U.S. Citizenship; non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy.
• Applicants tentatively selected for VA employment in a testing designated position are subject to urinalysis to screen for illegal drug use prior to appointment.
• Selective Service Registration is required for males born after 12/31/1959.
• Subject to background/security investigation.
• Selected applicants will be required to complete an online onboarding process.
• Acceptable form(s) of identification will be required to complete pre-employment requirements.
• Must pass pre-employment physical evaluation/examination.
• Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP).
• You may be required to serve a probationary period.
• Complete all application requirements detailed in the "Required Documents" section of this announcement.
• 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.
• 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.)
• 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.

Nice To Haves

• 3 - 4 years nursing experience in Case Management, Acute Care, Home Health and/or Hospice specialty areas.

Responsibilities

• Provides patient management, care coordination, and discharge/disposition planning for inpatient and outpatient settings.
• Assesses, plans, implements, and evaluates care based on age-specific components.
• Coordinates care focused on patient education, self-management, and customer satisfaction throughout the continuum of care.
• Provides competent, evidence-based care to assigned patients.
• Assists Veterans, family members, and caregivers with receiving the most appropriate options and services to meet their complex health care needs.
• Coordinates care with multiple providers across all levels and sites of care, ensuring services interface within the Veterans Affairs (VA) and HCBC programs for continuity of care.
• Performs clinical nursing review of medical records of patients hospitalized in non-VA hospitals to determine stability for payment and potential transfer to a VA facility.
• Maximizes third-party payments for care and delivers quality patient care improvement activities.
• Develops and coordinates transitioning of patients throughout the inpatient and outpatient care process with a focus on discharge planning needs.
• Reviews and assists in patient referrals to HCBC facilities to ensure continuity of qualified comprehensive care.
• Participates in discharge planning assessment and implementation of community health services.
• Performs follow-up and oversight visits to the Veteran after admission to HCBC to ensure adequate and safe care is being provided under VA contract.

Benefits

• 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

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: Associate degree