Registered Nurse-Utilization Management/Discharge Coordinator

Demonstrate proficiency in practice based on conscious and deliberate planning. Self-directed in goal setting for managing complex client situations. Assesses, plans, implements, and evaluates the effectiveness of the Veteran's 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.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 competence in practice and decision-making, deliberate planning, and critical thinking skills. The Utilization Management/Discharge Coordinator is responsible and accountable to the Chief of Community Care Services. The RN Case manager is responsible to facilitate care along the continuum through effective resource coordination to help patients achieve optimal health, access to care and appropriate utilization of resources, balanced with the patient's resources and right to self-determination. The RN Case Manager will provide clinical care of veterans who are inpatient at Joint Venture and Contracted health care facilities including, but not limited to, William Beaumont Army Medical Center and Community Care sites. The individual in this position has overall responsibility for ensuring that care is provided at the appropriate level of care based on medical necessity and to assess the patient for transition needs to promote timely throughput, safe discharge and prevent avoidable readmissions. This will require coordination of and referrals to various levels of care including non- institutional care and home and community-based services The RN is responsible for monitoring veteran status while inpatient, determination of coverage following eligibility criteria. Documenting in CPRS, and tracking admissions and discharges. Educating providers if needed. Communicating with the PUMA (Physician Utilization Management Advisor) regarding transfers to Inpatient Rehab/L TAC for patients meeting criteria. Applying and implementing lnterQual/MCG guidelines VHA and EPVAHCS approved criteria for coverage determination. Documents admission, changes in care to the point of discharge. The UM/DC 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 UM/DC Coordinator will utilize delegation of authority, if applicable, to function at their highest level of role performance and ensure highest quality standard of care.VA offers a comprehensive total rewards package: VA Nurse Total RewardsPay: Competitive salary, regular salary increases, potential for performance awardsPaid 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 VAInsurance: 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 territoryWork Schedule: Monday-Friday; 0800-1630Telework: Available Ad Hoc OnlyVirtual: This is not a virtual position.Relocation/Recruitment Incentives: Not AuthorizedPermanent Change of Station (PCS): Not Authorized