The Registered Nurse Care Coordination and Consult Specialist is assigned to the TVHS Nursing Services Surgical Specialty Clinics. The Nurse functions directly to support the activities of the Nursing service and assigned tasks related to care coordination and consults. The Registered Nurse Care Coordination and Consult Specialist is assigned to the TVHS Nursing Services. The Nurse functions directly to support the activities of the Nursing service and assigned tasks related to care coordination and consults. The Nurse is responsible for the planning, integrating, implementing, modifying and evaluating the effectiveness of the Veteran's care. The foundational elements will serve to support delivery of high quality, timely care to the Veteran receiving services in the community. The Registered Nurse is the lead of the integrated care team established by the VA Community Care Operating Model. He/she is responsible for providing clinical leadership and expertise on consults, community care processes and regulations. The Registered Nurse will serve as a liaison to both internal and external providers and will be responsible for managing the care of the Veteran and the seamless transition to and from the community. He/she possesses the knowledge related to VHA guidelines, utilization review criteria, current evidence-based standards of care, compliance guidelines and local policy related to Delegation of Authority as established by the facility Chief of Staff. Core elements of performance include knowledge and active participation in unit/program level quality improvement processes and initiatives as well as customer service programs. The nurse's primary commitment is to the patient, whether an individual, family, group, or community. The Nurse demonstrates leadership in delivering and improving holistic care through collaborative strategies with others. The nurse is a PROFICIENT nurse, "who understand a situation as a whole, because they perceive its meaning in terms of long-term goals. The proficient nurse learns from experience what typical events to expect in each situation and how plans need to be modified in response to these events. The proficient nurse can now recognize when the expected normal picture does not materialize; decision-making is less labored. The proficient nurse considers fewer options and hones in on an accurate region of the problem" (Benner), identifying emerging issues on the unit that need to be addressed. The Nurse practice affects unit, team, or work group. The Nurse demonstrates the ability to identify an issue, analyze it, and develop and implement interventions. The Nurse looks for opportunities to improve practice or functions at the unit level for a group of patients, using group process to accomplish this, for example, organizing, leading, or facilitating interdisciplinary team meeting. Care will be provided in the least restrictive, most cost-effective manner through use of the clinical practice guidelines and clinical pathways. Evidence of health promotion and chronic disease indices will be monitored through the clinical practice guidelines and performance measures. The eight core competencies of the High Performance Development Model (HPDM) and the Veterans Administration Core Values of ICARE incorporated into the dimensions of practice that support their application. Preferred Experience: Certification in Case Management preferred, MSN preferred Pay schedule NY72 Care Coordinator Work Schedule: Monday -Friday Financial Disclosure Report: Not required
Providing Health Care for Veterans: The Veterans Health Administration is America’s largest integrated health care system, providing care at 1,255 health care facilities, including 170 medical centers and 1,074 outpatient sites of care of varying complexity (VHA outpatient clinics), serving 9 million enrolled Veterans each year.