Registered Nurse(Community Care Clinical Coordinator)

Registered Nurse(Community Care Clinical Coordinator)

Department: Department of Veterans Affairs

Location(s): Redlands, California

Salary Range: $102327 - $185094 Per Year

Job Summary: The Community Care RN Clinical Coordinator is a registered professional nurse, qualified by education and experience to provide direct staff support in planning, designing, integrating, implementing, modifying, and evaluating the effectiveness of program components and/ or services to improve the quality of patient care and the appropriateness and timeliness of services provided.

Major Duties:

• The Community Care RN Clinical Coordinator is aligned within the Office of Community Care and is responsible for providing the clinical leadership and expertise for the coordination of the medical center's non-VA care authorization program. He/she possesses intimate knowledge of Fee federal regulations, VHA guidelines, medical review criteria, utilization management processes, clinical documentation requirements, current standards of care, and compliance guidelines. Clinical oversight of the non-VA care approval process is provided by the medical center Chief of Staff or designee. The incumbent supports the medical center's mission by possessing and exemplifying the core competencies of the High Performance Model .The Community Care RN Clinical Coordinator is supervised by the VACC Clinical Nurse Manager whose immediate supervisor is the Chief of Community Care. Special consideration is given to nurses with experience in Care Coordination nurses with case management/fee service training, and nurses with leadership training or demonstrated competence in these areas. This nurse must be self-motivated, flexible and possess excellent patient documentation skills. He/she is responsible for providing the clinical expertise for the coordination of the medical center's Non VA Care and COMMUNITY CARE programs. .The Community Care RN Clinical Coordinator utilizes comprehensive knowledge of advanced clinical practice and UM principles to assess appropriate level of care and to ensure compliance with established guidelines resulting in approvals and/or denials for Community Care. - Conduct clinical reviews to interpret and evaluate complex data directly related to diagnosis, condition, and treatment to assure appropriate medical necessity, appropriate care coordination and timely utilization of non-VA health care services. - Execute position responsibilities that demonstrate leadership, experience, and creative approaches to management of complex client care within VHA Community Care program. - Organize and coordinate the clinical components for the authorization of Community Care & Non-VA services in response to individual healthcare needs along the illness and care continuum. - Center services around the patient, to foster patient self-managed care, and maximize efficient and cost effective use of health care resources. - Utilize all avenues of resources available to provide safe and efficient timely coordination of quality health care and services. - Assist in completion of Med Doc reviews. - Manages entire episode of care in the community and re-integration into VA services. - Performs clinical triage of VA Community Care referrals. - Educates Veterans and family/caregivers on care coordination process. - Communicates with patient and serves as consistent point of contact throughout episode of care. - Coordinates ancillary services provided by the VA in conjunction with episodes of care in the community (DME, medications, rehab, etc.) - Conducts comprehensive assessment of the Veteran and the Veteran's family/caregiver needs. - Collaborates with internal VA providers and community providers. - Manages requests for secondary authorizations. - Completes consult with a clinical summary of care provided. Preferred Experience: 5 year RN Experience 2 years Care coordination experience. BSN preferred Be acquainted with clinical treatment modalities Advanced knowledge of programs including Vista Imaging and Vista Capture Advanced knowledge with working with the TriWest Portal Work Schedule: Monday-Friday, Shift TBD Telework: Not Available Virtual: This is not a virtual position. Financial Disclosure Report: Not required

Qualifications: 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. U.S. Citizenship; non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. 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.) 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/12828863. 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. Reference: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/. Physical Requirements: Pushing; Straight pulling; Pulling hand over hand; Reaching above shoulder; Use of fingers; Both hands required; Walking (up to 6 hours); Standing (up to 6 hours); Kneeling (Intermittent);Repeated bending (up to 6 hours); Both legs required; Ability for rapid mental and muscular coordination simultaneously; Near vision correctable at 13" to 16"; Far vision correctable in one eye to 20/20 an to 20/40 in the other; Ability to distinguish shades of colors; Hearing (aid permitted); Emotional and Mental Stability.**If 10 hours shifts hours of moving, bending, standing, walking will be 10 hours.

How to Apply: All applicants are encouraged to apply online. To apply for this position, you must complete the full questionnaire and submit the documentation specified in the Required Documents section below. The complete application package must be submitted by 11:59 PM (ET) on 11/14/2025 to receive consideration. To preview the questionnaire click https://apply.usastaffing.gov/ViewQuestionnaire/12828863. To begin, click Apply Online to create a USAJOBS account or log in to your existing account. Follow the prompts to select your USA JOBS resume and/or other supporting documents and complete the occupational questionnaire. Click Submit My Answers to submit your application package. NOTE: It is your responsibility to ensure your responses and appropriate documentation is submitted prior to the closing date. During the application process you may have an option to opt-in to make your resume available to hiring managers in the agency who have similar positions. Opting in does not impact your application for this announcement, nor does it guarantee further consideration for additional positions.

Application Deadline: 2025-11-14