Registered Nurse- Facility Care Coordination and Integrated Case Management Coordinator
Minneapolis, MN - USA
Job Summary
The Facility Care Coordination and Integrated Case Management (CCICM) Coordinator Registered Nurse (RN) is responsible for providing competent evidence-based care to assigned patients. Demonstrates leadership in delivering and improving holistic care through collaborative strategies with others.
Major duties include but are not limited to:
- The CCICM Coordinator is administratively responsible in collaboration with the CCICM Social Worker (SW) for the clinical programming and daily operations of the CCICM throughout the facility.
- Develops and implements policies and procedures to ensure compliance with the local facility Veterans Integrated Systems Network VISN) Office of Nursing Services ONS) and Veterans Affairs Central Office (VACO) directives and handbooks.
- Develops and implements a facility level framework for implementation of national standardized processes and tools that integrate communication collaboration and coordination across services and programs to expand upon existing Veterans Health Administration VHA) program approaches and address concerns about care coordination service delivery gaps and service duplication.
- Participates in the development of policies procedures and practice guidelines for the program and participates in facility VISN and national program development as related to CCICM.
- Provides guidance and support in the implementation and maintenance of the program through education training mentorship and coaching.
- Develops implements and tracks facility wide CCICM education plan to key stakeholders.
- Ensures full collaboration with social work counterpart for all planning development implementation monitoring and evaluation of the CCICM operations.
- Manages monitors evaluates and reports on all CCICM related data to fully capture the day-to-day functioning and practice impacts on the facility and Veteran care.
- Identifies Veteran cohorts across the facility with the highest opportunity and highest need; including development and implementation of a monitoring process for ongoing screening and identified cohort(s).
- Actively participates in the treatment planning process with other disciplines including involvement in discharge planning with other disciplines and will be responsible for ensuring that discharge plans are executed in a manner that are timely and appropriate.
- Ability to develop needed community support and/or resources to ensure the program goals are achieved.
- Provides direct patient care services to identified high utilizer/at-risk Veterans to ensure appropriate services are in place to support the CCICM framework.
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: Monday- Friday 7:30am-4:00pm
Telework: ADHOC-May be authorized (Employee who Telework on an occasional episodic or short-term and have completed required telework training and telework agreement).
Virtual: This is not a virtual position.
Relocation/Recruitment Incentives: Not Authorized
Permanent Change of Station (PCS): Not Authorized
The VA Midwest Health Care Network advocates for a Whole Health System of care in each of the Medical Centers. This is an approach to healthcare that empowers and equips people to take charge of their health and well-being and live their lives to the fullest. As an employee operating in a Whole Health System of care you will operate in a model with three core elements seeking to create a personalized health plan for each Veteran. This is done in the context of healing relationships and healing environments and a connection back to the Veterans community. This aligns with the Veterans Health Administration (VHA) Mission Statement to Honor Americas Veterans by providing exceptional health care that improves their health and well-being.
- 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.
- Must pass pre-employment physical evaluation.
- 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.)
Preferred Experience:
- Management/supervision experience.
- Program management experience and work with Veterans managing moderate to complex care coordination/case management needs.
- Strong skills in informatics including data management and knowledge/use of xcel.
Grade Determinations: The following Scope Education and Dimension criteria must be met in determining the grade assignment of candidates and if appropriate the level within a grade. The Dimension requirements (Practice Veteran/Patient Driven Care Leadership Professional Development and Evidence-Based Practice/Research) are detailed for each grade and level within the online assessment: I Level I
Reference: For more information on this qualification standard please visit Requirements: You will be asked to participate in a pre-employment examination or evaluation as part of the pre-employment process for this position. Questions about physical demands or environmental factors may be addressed at the time of examination.
This job opportunity announcement may be used to fill additional vacancies.
This position is in the Excepted Service and does not confer competitive status.
VA encourages persons with disabilities to apply. The health-related positions in VA are covered by Title 38 and are not covered by the Schedule A excepted appointment authority.
If you are unable to apply online or need an alternate method to submit documents please reach out to the Agency Contact listed in this Job Opportunity Announcement.
Under the Fair Chance to Compete Act the Department of Veterans Affairs prohibits requesting an applicants criminal history prior to accepting a tentative job offer. For more information about the Act and the complaint process visit Human Resources and Administration/Operations Security and Preparedness (HRA/OSP) at The Fair Chance Act.
Candidates should be committed to improving the efficiency of the Federal government passionate about the ideals of our American republic and committed to upholding the rule of law and the United States Constitution.
A career with the U.S. government provides employees with a comprehensive benefits package. As a federal employee you and your family will have access to a range of benefits that are designed to make your federal career very rewarding. Opens in a new windowLearn more about federal benefits.
Eligibility for benefits depends on the type of position you hold and whether your position is full-time part-time or intermittent. Contact the hiring agency for more information on the specific benefits offered.
Required Experience:
IC