Registered Nurse - Care Coordinator/Integrated Case Management Nurse Manager
Veterans Affairs, Veterans Health Administration
Location: Big Spring, Texas
Internal Number: 629371900
Announcement is extended until 01/20/22 The Care Coordination & Integrated Case Management-Nurse Manager (CC&ICM NM) position is located at the VA in Big Spring, TX. The goal of the CC&ICM-NM is to ensure effective and efficient coordination of care along a seamless continuum to enhance Veterans' experience through the assignment of a case manager or lead coordinator for Veterans with moderate to complex care needs. The RN - CC&ICM NM collaborates with the Chief of Staff (COS), Associate Director, Patient Care Service (ADPCS), Deputy Associate Director, Patient Care Service (DADPCS), Chief of Social Work, RN Case Managers (CM), Disease Manager (DM), Clinical Access Manager (CAM), Patient Aligned Care Teams (PACT), Social Workers and others as needed support the delivery of high quality care coordination in a consistent manner, by well-trained and responsive Case Managers and in partnership with social work, referral coordination team (RCT), community care service (CCS), PACT and other services as necessary. CC&ICM Nurse Manager focuses on preserving Veterans' functionality, effective use of resources (e.g., MOVE, CM, DM & Utilization Management (UM)), assisting Veterans in leading healthier lifestyles and improving quality of life by appropriate access to care. Uses knowledge about CC&ICM, RCT, CCS, and PACT and leads and facilitates the coordination, communication, and consistent implementation of and the integration into clinical practice. Oversees the productivity, processes, and case management activities of all staff aligned under the CC&ICM. Will serve as the organizational subject matter expert (SME) for care coordination and all processes related to CC&ICM. Assists with the development of policies and procedures, contributes to the community of practice across the Veterans Health Administration (VHA) through use of a data-driven quality improvement approach to case management practice with established goals and outcomes to evaluate and document case management effectiveness. The CC&ICM-NM is required to perform statistical reporting, evaluation, consultation, and collaborate with non-Department of Veterans Affairs (VA) facilities as well as other VA health care facilities, professionals, other disciplines and services as necessary. Uses available data sources (e.g., Strategic Analytics for Improvement and Learning (SAIL), VHA Support Service Center (VSSC) etc.) to identify, assess, and prioritize the needs of targeted subsets of Veterans for population needs. Uses data-driven processes to prospectively and retrospectively identify indicators of ineffective or inefficient delivery of care including, but not limited to, high-cost, high-volume, or problem-prone diagnoses, procedures, and services, and high utilization rates for services (e.g., pharmacy, Urgent/Emergency Care, Ambulatory Care Sensitive Conditions Ambulatory Care Sensitive Conditions (ACSC), and outpatient visits). Makes recommendations for cost containment or process improvements. The incumbent must be able to comprehend and maintain knowledge of current organizational policies, VA guidelines, policies, Federal regulations, and laws governing medical benefits for Veterans. Practices effective public speaking skills and the ability to communicate effectively, both orally and in writing, with a wide variety of individuals and organizations. Collaborates with all stakeholders, (e.g., COS, ADPCS, DM, CM, RCT, CCS, CAM, PACT) develop and evaluate an annual CC&ICM strategic plan to include but not limited to DM, CM strategies, and UM for high-cost, high-volume, and high patient utilizers, environmental, educational, motivational, and clinical activities designed to encourage improvement in health behaviors and conditions of living that are conducive to improving the health and well-being of our population and individuals. Ensures interventions to reduce health risks include system-level, provider-level, and patient-level strategies that assist the population/individuals in changing risky behaviors and adopting healthier ones (e.g., implementation of Clinical Practice Guidelines (CPG)). Actively participates in meetings, workgroups, and/or committees as appropriate or as assigned, and possibly serves as the chair on committees. Conducts peer reviews as indicated. Work Schedule: Monday - Friday, 8am - 4:30pm Telework: Not Available Virtual: This is not a virtual position. Relocation/Recruitment Incentives: Not Authorized 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.