RN Salary Range: Candidate's education and length of nursing practice (experience) will be considered by a Nurse Professional Standards Board in determining the grade and salary of the applicant selected. The recommended salary may be at any point in the range listed for this vacancy. The Community Care Nurse Coordinator registered nurse is directly responsible to the VA Community Care Lead RN and/or the VA Community Care Program Manager. The Community Care Nurse Coordinator RN demonstrates clinical leadership and expertise for the implementation of the third-party utilization review reimbursement program. He/she possesses intimate knowledge of third-party medical review criteria, utilization review criteria, utilization review processes, clinical documentation requirements, current standards of care, and compliance guidelines. The Community Care Nurse Coordinator RN is accountable for utilizing critical thinking skills and sound judgment to ensure positive outcomes, maximizing third party collections and delivering quality patient services. The incumbent provides leadership for and participates in the performance improvement activities within the assigned role. He/she must possess the ability to interact with a wide variety of employees and work independently in accomplishing assignments and program goals. The incumbent assists in providing direction, planning and implementation of a fully integrated revenue utilization review program. The incumbent supports the mission by possessing and exemplifying the eight core competencies of the high-performance development model. The incumbent is also responsible for providing advanced clinical and administrative recommendations relative to programs, committees, and/or services that relate to Community Care. The incumbent utilizes expert nursing judgment and knowledge of treatment modalities to review patient medical records for service connection, VA availability and emergent nature according to established criteria. The incumbent assists with all clinic issues in other areas of the Community Care Programs such as Pre-authorized referrals, Mill Bill claims, and Special Programs. Work Schedule: Monday-Friday, 8:00 am - 4:30 pm Financial Disclosure Report: Not required
Internal Number: 600087600
About Veterans Affairs, Veterans Health Administration
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.