The incumbent will serve as a Registered Nurse for the Care in The Community program for the Louis A. Johnson VA Medical Center, Clarksburg, WV CARE IN THE COMMUNITY RN MAJOR DUTIES: Directs the review, scheduling and authorization of VA Community Care Consults. Possesses intimate knowledge of Fee federal regulations, VHA guidelines, medical review criteria, utilization management processes, clinical documentation requirements, current standards of care, and compliance guidelines. Collaborates with Service Line Director regarding complex medical needs and consults. Assists care units with Community care basis referrals/hospitalizations ensuring appropriate resource utilization of VA care at other facilities, or when it is determined either that VA services are not available, or the veteran cannot travel to a VA because of a medical condition. Coordinates discharge orders/needs after hospitalizations between patients, VA provider and outside provider. Contacts patients/families to provide patient education related to consults or follow-up activities. Assumes the role of point of contact for VA and community care referrals, ensuring that necessary documentation is sent to and received from the community vendors in order to facilitate patient care. Assesses the tracking and monitoring of cancellations, "no show" activity, and follows up with patient and providers, and takes action to resolve or improve the outcomes. Establishes and maintains close networking relationships with VA/community care RNs at other health care facilities to ensure similar decision making is utilized for clinical reviews. Leads the effort to improve co-managed care contacts and processes. Ensures continuity across the continuum of care. Additional duties as assigned. Work Schedule: 8:00AM -4:30P MON-FRI SUBJECT TO CHANGE BASED ON MEDICAL CENTER NEEDS 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.