The primary purpose of this position is to provide patient care and care coordination, as it pertains, to Specialties while assigned as a Specialty Care Clinic (SCC) Nurse Coordinator (NC) at the Mann-Grandstaff VA Medical Center (MGVAMC) in Spokane, Washington. The SCC NC/RN is responsible for implementation, care coordination, direct patient care as well as delegation of care delivered in the Specialty Care Clinic and the programs that are supported by the Specialty Care Clinics. Duties include but are not limited to: The incumbent will function in an independent manner under the direction of the Nurse Manager of the SCC. Uses the nursing process and evidence-based practice to collaborate with the Core Team (Patient, Specialty Care Provider, SCC NC/RN, LPN, Health Technician/Nurse Assistants, MSA and other clinics) and Expanded Team (family/caregiver, internal and community-based services involved in providing care to the patient). Functioning at the full extent of the team member's relevant clinical privileges, credentials, scopes of practice, elements of practice, certification, functional statement, position description, or other VHA or local facility approved documentation of competency. Collaborates clinic needs and assignments with other specialty care coordinators in order to meet the needs of the Veterans seen in SCC. Coordinate with surgeon's surgery block time. Floats as need to other Specialty Care Clinics. Provides medications as ordered in the care management of Veterans. Prepares Veteran for clinics, surgery, and assist providers with procedures and obtaining lab specimens. Executes position responsibilities that demonstrate leadership, experience, and creative approaches to the management and advocacy of complex Veteran care in a timely manner within the parameters of the Veterans Affairs regulations. Collaborates effectively with all members of the Core Team and the Expanded Team across the continuum of care and serves as a role model for professional growth, development and practice. Ensuring appropriate evaluation, triage and care coordination of complex Veterans to ensure access is provided to the Veteran via clinics, community or VA facilities. Works closely with the Veterans to ensure smooth transition of care and processes of referrals ensuring necessary pre-referral testing, labs, imaging and clinical records associated with the referral are communicated to the clinic, community or VA facilities. Care will be provided in the least restrictive, most cost-effective manner, through use of the clinical practice guidelines and clinical pathways. Assist with significant collaboration with community and VISN healthcare personnel in the transition of Veterans through the VA Healthcare System. Participating in team performance improvement and sustainment activities to optimize team efficiency and care delivery to Veterans. Managing communications and facilitating safe transitions of Veterans between the specialty clinic site of care and other health care settings, using informal and formal communication methods, as appropriate. Using formal and informal communications that are respectful, effective, timely, and bidirectional with all team members (including the Veteran and personal support persons) to convey significant, clinically relevant information for the care of the Veteran. Providing health promotion, health education and health coaching on wellness, disease prevention, chronic care management, and self management skills to Veterans and personal support persons based on the Veteran's goals. Engaging Veterans in using health care, encouraging Veterans to engage personal support persons, receiving input from Veterans and personal support persons regarding VA care. Collaborating with informatics technology staff to develop and implement systematized, electronically supported, standardized, tools to support Specialty Care Clinic delivery processes (e.g., pre-visit reminder calls, post hospitalization follow-up calls, consult (referral) management, recall scheduling procedures, new Veteran orientation, outpatient care/specialty care protocol use and management). Provide quality and performance measures analysis and reporting of consult (referral) trends and systems issues through the. utilization of the nursing process. Incumbent will be self-directed in completing on-going education. Will ensure the appropriate staff has completed annual competency checklists. Work Schedule: Monday thru Friday, 0700-1730, Day off TBD. Compressed/Flexible: Available, 10 hour tours Telework: Not available Virtual: This is not a virtual position. Relocation/Recruitment Incentives: Not authorized Permanent Change of Station (PCS): Not authorized Financial Disclosure Report: Not required Pay: Competitive salary, regular salary increases. Paid Time Off: Annual leave at the rate of eight (8) hours per biweekly pay period; Sick leave at the rate of four (4) hours per biweekly pay period; 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.
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.