Registered Nurse Community Care Coordinator

General Description of Assigned Duties:
Responsible and accountable for all elements of the nursing process when providing and/or supervising direct patient care. Assesses plans implements and evaluates the effectiveness of the Veterans care. Serves to support delivery of high quality timely care to the Veteran receiving services in the community. Assumes responsibility for the coordination of care focused on patient education self-management and customer satisfaction throughout the continuum of care. Follows procedures per established policies and guidelines. Influences care outcomes by collaborating with members of the interdisciplinary team. Core elements of performance include knowledge and active participation in the unit/program level quality improvement process and initiatives as well as customer service programs. Executes position responsibilities that demonstrate leadership experience and creative approaches to management of complex client care.

Functions or Scope of Assigned Duties:
The Community Care (CC) Coordinator Registered Nurse (RN) is responsible for executing a streamlined approach to receiving triaging and directing timely coordinated care. The nurse demonstrates proficient practice and decision-making deliberate planning and critical thinking skills. The CC Coordinator possesses intimate knowledge of the internal referral care process clinical review criteria utilization management standards clinical documentation requirements community care regulations and Veterans Health Administration (VHA) standards and guidelines. The CC Coordinator uses nursing knowledge and systems theory to assess organize facilitate and guide Veterans through their full range of care options including internal/direct care in Veterans Affairs (VA) and care in the community. The CC Coordinator serves as a liaison to both internal and community providers and is responsible for managing the care of the Veteran throughout the consult process. The CC Coordinator supports the medical centers mission to improve timely access to care ensure Veterans who want to receive care in the community are referred and scheduled into the community and support the delivery of high quality timely care to the Veteran receiving community services.

The CC Coordinator will work collaboratively within the Office of Integrated Veteran Care (IVC) to triage Request for Services (RFS) to coordinate care processes defined by the IVC Field Guidebook to include developing a care coordination plan reviewing medical documentation from community providers communication of care coordination needs and supporting the Veteran through the completion of the episode of care. The CC Coordinator will influence care outcomes by collaborating with members of the interdisciplinary team both within the Veterans Affairs (VA) and in the community. The CC Coordinator will comply with VA-mandated processes and use of health information solutions that serve to assess document exchange and track care coordination information. The CC Coordinator will utilize delegation of authority if applicable to function at their highest level of role performance and align high-quality care with key performance indicators to ensure practice standards meet patient care needs. Supports colleagues and other nurses through knowledge sharing to provide safe quality nursing care. Fosters a safe and supportive environment conducive to the professional development of health care professionals. Evaluates outcomes of evidence-based decisions and practice changes for individuals groups and populations. Responsible for the documented outcomes at the program or service level. Program or service level outcomes must be broad and complex and can be demonstrated at any organizational level within a facility.

VA offers a comprehensive total rewards package: VA Nurse Total Rewards

Pay: Competitive salary regular salary increases potential for performance awards
Paid Time Off: 50 days of paid time off per year (26 days of annual leave 13 days of sick leave 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

Work Schedule: Full-Time; Monday to Friday 0800-1630
Telework: Not Available
Virtual: This is not a virtual position.
Relocation/Recruitment Incentives: Not Authorized
Permanent Change of Station (PCS): Not Authorized

• U.S. Citizenship; non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy.
• All applicants tentatively selected for VA employment in a testing designated position are subject to urinalysis to screen for illegal drug use prior to appointment. Applicants who refuse to be tested will be denied employment with VA.
• 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 ( Effective May 7 2025 drivers licenses or state-issued identification cards that are not REAL ID compliant cannot be utilized as an acceptable form of identification for employment.
• Physical aspects associated with work required of this assignment are typical for the occupation and would generally not require a pre-placement 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.

Basic Requirements:

• English Language Proficiency. In accordance with 38 U.S.C. 7403(f) 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 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 masters level bridge program in nursing who have completed coursework equivalent to a bachelors 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. Upon achievement of a State license the individual may be appointed on temporary basis and later converted to a permanent appointment upon successful completion and graduation from the bridge program. (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 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.)