Registered Nurse-Referral Care Coordination

Created at: August 13, 2025 00:13

Company: Veterans Health Administration

Location: Hobbs, NM, 88240

Job Description:

Responsible and accountable for all elements of the nursing process when providing and/or supervising direct patient care. Assesses, plans, implements, and evaluates care based on age specific components. 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.
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 master's level bridge program in nursing who have completed coursework equivalent to a bachelor's 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.) HPTs who are on track to graduate/complete the requirements should respond as if they have met the requirements. Provide details in the narrative sections of the assessment. NOTE: Grandfathering Provision - All persons currently employed in VHA in 0610 series and performing the duties as described in the qualification standard on the effective date of the standard (1/29/2024) are considered to have met all qualification requirements for the grade held including positive education and licensure/certification. 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: https://apply.usastaffing.gov/ViewQuestionnaire/12781857. Grade/Level Scope Education Nurse I, Level I Delivers fundamental, knowledge-based care to assigned clients while developing technical competencies. An Associate Degree (ADN) or Diploma in Nursing, with no additional professional nursing required. Nurse I, Level II Demonstrates integration of biopsychosocial concepts, cognitive skills and technically competent practice in providing care to clients with basic or complex. An ADN or Diploma in Nursing AND 1 year of specialized nursing experience equivalent to Nurse I, Level 1 ;OR a Bachelor of Science in Nursing (BSN) with no additional professional nursing experience required. Nurse I, Level III Demonstrates proficiency in practice based on conscious and deliberate planning. Self-directed in goal setting for managing complex client situations. An ADN or Diploma in Nursing AND 2 years of professional nursing experience in which one year is equivalent to Nurse I, Level 2; OR a BSN and 1 year of professional nursing experience equivalent to the Nurse I, Level 2; OR a Master's degree in nursing (MSN) and no additional professional nursing experience; OR a Master's degree in a *related field with a BSN and no additional professional nursing experience. Nurse II Demonstrates leadership in delivering and improving holistic care through collaborative strategies with others. A BSN with 2 years of professional nursing equivalent to Nurse I, Level 3; OR an MSN with one year of specialized nursing experience equivalent to Nurse I, Level 3; OR a Master's degree in a *related field with a BSN and one year of specialized nursing experience equivalent to Nurse I, Level 3; OR a Doctoral degree in Nursing with no professional nursing experience; OR a Doctoral degree in a *related field with a BSN with no additional professional nursing experience. Nurse III Executes position responsibilities that demonstrate leadership, experience and creative approaches to management of complex client care beyond the immediate practice setting. MSN and 2 years of specialized nursing experience, one of which is equivalent to Nurse II and meets all dimension requirements for Nurse III; OR a Master's degree in *related field with BSN and two years of specialized nursing experience, one of which is equivalent to Nurse II and meets all dimension requirements for Nurse III; OR a Doctoral degree in Nursing with and one year of specialized nursing experience equivalent to Nurse II and meets all dimension requirements for Nurse III; OR a Doctoral degree in a *related field with a BSN and one year of specialized nursing experience equivalent to Nurse II and meets all dimension requirements for Nurse III. *Note: Foreign education programs/degrees are not creditable as related degrees. Preferred Experience: Minimum of one (1) year Case Management and/or Care Coordination experience required. Minimum two (2) years medical-surgical nursing experience with the adult population. Minimum two (2) years experience with hospital Electronic Medical Record (EMR) charting documentation and Microsoft Office products. Strong computer skills are required. Customer service and conflict resolution experience necessary. Ability to communicate professionally/effectively in both written and verbal correspondence, on the phone, and/or in-person. Ability to multi-task between interdisciplinary stakeholders, maintain organization of tasks in high-paced, intensive work environment. Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/. Physical Requirements: Lifting up to 35·pounds for 8-12 hours, intermittently, moderate carrying (15-35 pounds) for 8 to 12 hours, intermittently, lifting over 35 pounds with assistive devices in accordance with the Safe Patient Handling Policy except in emergent situations requiring prompt patient care, pulling for 8 to 12 hours intermittently, pushing for 8-12 hours, intermittently, reaching above the shoulders for 8-12 hours, intermittently, both hands required, walking 8-12 hours, intermittently, standing 8-12 hours intermittently, kneeling 8 to 12 hours, intermittently, repeated bending for 8-12 hours, intermittently, climbing and use of both legs and arms for 8-12 hours, intermittently, both legs required, near vision at 13 to 16" Jaeger 1 to 4, far vision correctable in one eye to 20/20 and to 20/40 in the other eye, ability to distinguish basic colors, hearing aid permitted, twisting, simple grasp and fine manipulation.
The Referral Care Coordination (RCC) 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 RCC RN 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 RCC RN 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 RCC RN 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 RCC RN supports the medical center's mission to improve timely access to care, empower Veterans to make more informed care decisions, ensure eligible 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 RCC RN will triage incoming referrals, discuss available care options, provide scheduling guidance, and be a resource within the service/organization. The RCC RN will guide Veterans through their full range of care options (e.g., internal/direct care in the VA, care in the community) utilizing a national standardized triage tool of other locally curated referral guideline resources. RCC RNs serve as the liaison between ordering or referring VA providers and specialty care services by clinically triaging consults or referrals to confirm the appropriate care is requested and all necessary pre-work and tests are completed. The RCC RN will comply with VA-mandated use of health information solutions that serve to story, exchange, and track referral care information. The RCC RN will work collaboratively with the Office of Integrated Veteran Care (IVC), as well as use the care processes defined by the Office of Integrated Veteran Care (IVC) Field Guidebook to triage Request for Services (RFS), to promote in-house service access, and/or to coordinate other care options. The RCC RN will utilize the IVC Field Guidebook to support role performance to include developing care coordination plans, reviewing medical documentation for community providers, communication of care coordination needs, and supporting the Veteran through the completion of the episode of care (EOC). Other duties as assigned. 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; 08:00am-04:30pm Telework: Available Ad Hoc Only Virtual: This is not a virtual position. Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized


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