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Veterans Affairs, Veterans Health Administration Home Teleheatlh Registered Nurse Care Coordinator in Bath, New York

Summary The Home Telehealth Registered Nurse Care Coordinator coordinates care for a panel of patients through-out the continuum of care for a variety of health conditions. The HT RN Care Coordinator works closely with program staff, the primary care provider (or providers), other healthcare professionals and team members, other clinics, internal or external services and community agencies, and medical center leadership. Responsibilities Duties May Include However Are Not Limited To The Following: The incumbent will coordinate care for a panel of patients through-out the continuum of care for a variety of health conditions including, but not limited to: hypertension, congestive heart failure, chronic obstructive pulmonary disease, diabetes mellitus, post traumatic stress disorder, dementia, depression/anxiety, bipolar disorder, schizophrenia, and weight management. Supervisory Control: The RN HT Care Coordinator is directly responsible to the Connected Care Program Manager, under the Nurse Executive. The RN HT Care Coordinator is additionally professionally and clinically responsible to the collaborative functioning of the Home Telehealth team. Functions and Responsibilities The RN HT Care Coordinator performs a full range of administrative and clinical duties, participates in complex clinical and technical decision-making, and assures the implementation and maintenance of standards for HT practice in their specified program. The individual provides leadership that is characterized by continuous responsibility and accountability for information and practice guidelines that impact patient care. The individual provides leadership as a nursing consultant in improving and sustaining the quality, safety and effectiveness of HT related processes which involve regular communication with clinical, administrative and technical staff both within the VA and with external organizations/vendor. The RN HT Care Coordinator exhibits leadership in providing safe patient care related to HT. Through instruction, consultation, collaboration, clinical and administrative responsibilities, the individual serves as a clinical resource for VA staff within his/her local area, i.e., medical, nursing, administrative, technical and management staff and the community in HT related performance improvement outcomes. Competency will be evaluated annually. The RN HT Care Coordinator uses the nursing process and evidence-based practice to collaborate with the PACT team members (Patient, Primary Care Provider, PACT nurses, Program Support Assistant (PSA), and LPN) and larger Team (family/caregiver, internal and community-based services involved in providing care to the patient) in developing the patient-driven holistic care plan for life. The RN HT Care Coordinator is responsible for collaborating with services internal and external to the VA to facilitate care transition in order to effectively meet the patients' needs. The RN HT Care Coordinator provides patient and family health education with a focus on self-management, prevention, and wellness, based on the patient's goals. The RN HT Care Coordinator demonstrates leadership by serving as an advocate for patients, team player to colleagues as she/he continues to enhance his/her own and the team's professional growth, development and practice. Duties & responsibilities include but are not limited to: Provides initial and ongoing assessment of patients to identify needs issues, care goals and appropriate resources necessary for care management. Assures accuracy of information provided in the forms of progress notes, reports, presentations, and briefings on program patients and operations. Provides leadership in application of the nursing process and identifies resources and critical factors for achieving desired outcomes for discharge, post hospitalization recovery and health maintenance/improvement. Sets clinical care goals, short and long term, in collaboration with patient, provider(s), and family members. Functions as a systems coordinator for the plan of care; monitors progress through the expected hospital course and intervenes as appropriate to facilitate achieving patient outcomes within anticipated timeframes. Coordinates care and discharge planning with the patient's primary care provider and team. Collaborates with patient and care providers in all settings where care is being provided to evaluate and update changes in the therapeutic plan of care and patient management. Recognizes complex situations that impact patient care and intervenes, using sound judgment, professional attitude and appropriate channels. Recognizes impact of age-specific care needs and incorporates this into the assessment process. Also, incorporates these age-specific needs into care as reflected by modification of treatment plans. Maintains a working knowledge of resources available in the community. Appropriately documents own interventions and oversee appropriate health team documentation of patient care. Work Schedule: Mon-Fri 7:30am-4:00pm This position currently requires rotating weekends on standby call in support of Covid-19 monitoring. Financial Disclosure Report: Not required Requirements Conditions of Employment Qualifications Preferred Experience: 2-5 Years RN Experience, Triage, Emergency Dept., Emergency Care. Basic Requirements: (1) Citizenship. Citizen of the United States. (Noncitizens may be appointed when it is not possible to recruit qualified citizens in accordance with chapter 3, section A, paragraph 3g, this part.) (2) Graduation from School of Nursing (a) Graduate of a school of professional nursing approved by the appropriate State agency, and accredited by one of the following accrediting bodies at the time the program was completed by the applicant. [NOTE: See exception in subparagraph (b) below for candidates who are enrolled in a MSN Bridge Program.] 1. The National League for Nursing Accrediting Commission (NLNAC), an accrediting arm of the National League for Nursing located at 61 Broadway, 33rd Floor, New York, New York 10006 or call (800) 669-1656 extension 153. The NLNAC accredits all levels of nursing programs. Additional information may be obtained from the NLNAC web site; or 2. The Commission on Collegiate Nursing Education (CCNE), an accrediting arm of the American Association of Colleges of Nursing (AACN). The CCNE accredits bachelors and masters degree programs, and is located at One Dupont Circle N.W., Suite 530, Washington, DC 20036 or call (202) 463-6930. Additional information may be obtained from the CCNE web site. (b) [The completion of coursework equivalent to a nursing degree in a MSN Bridge Program that qualifies for professional nursing registration constitutes the completion of an approved course of study of professional nursing. In these programs, students are given a certificate of professional nursing to sit for the NCLEX and should submit this certification to VA prior to appointment. Students do not earn a BSN, but receive a MSN degree upon completion of course work. A copy of the MSN transcript must be provided to VA. Bridge programs that confer a master's degree also fully meet the education requirement, even though a Bachelor's Degree is not awarded. (c)] In cases of graduates of foreign schools of professional nursing, possession of current, full, active, and unrestricted registration (see paragraph 2a(3)) will meet the requirement of graduation from an approved school of professional nursing. NOTE: Most individuals admitted as permanent residents or adjusting to permanent resident status as registered nurses on or after December 14, 1998, for the purpose of working as a registered nurse, must meet the certification requirements in Section 343 of the Illegal Immigration Reform and Immigrant Responsibility Act (Pub. L. 104-208, September 30, 1996). This certification involves a review of the alien's education, training, license(s), and experience, verification that the alien possess an acceptable level of competence in written and oral English, and a requirement that the individual has passed either the Commission on Graduates of Foreign Nursing Schools (CGFNS) Qualifying Examination or the National Council of State Boards of Nursing, Inc. examination, the NCLEX-RN. For additional information see Pub. L. 104-208, 63 Federal Register 55007-55012, dated October 14, 1998, and the CGFNS web site. (3) Registration (a) Condition of Employment. A registered nurse (RN) will have a current, full, active and unrestricted registration as a graduate professional nurse in a State, Territory, or Commonwealth (i.e., Puerto Rico) of the U.S. or in the District of Columbia. The appointing official may waive this registration if the RN is to serve in a country other than the U.S. and the RN has registration in that country (e.g., Philippines). The RN must maintain a current, full, active and unrestricted registration to continue employment with VA. (b) Impaired Registration. An impaired registration is any registration(s) revoked, suspended, denied, restricted, limited, or issued/placed in a probationary status. A registered nurse who has or ever had any such impairment to their registration as listed above may be appointed only in accordance with the provisions of chapter 3, section B, paragraph 15 of this part. (4) Physical Standards. See VA Directive and Handbook 5019. A pre-employment physical examination will be required. This position requires visual acuity, keen hearing, clear distinctive speech, and manual dexterity. This position requires potentially long periods of continued walking, standing, stooping, sitting, bending, pulling, and pushing. Transferring patients and objects may be required. Mechanical patient lifts are provided. The incumbent may be exposed to infected patients and contaminated materials and may be required to don protective clothing in isolation situations or operative/invasive procedures. The incumbent may occasionally be exposed to patients who are combative secondary to delirium, dementia, or psychiatric disorders. The incumbent must be a mature, flexible, sensible individual capable of working effectively in stressful situations, able to shift priorities based on patient needs. Must complete annual Employee Health requirements, such as annual TB screening or testing, as a condition of employment. (5) English Language Proficiency. RNs appointed to direct patient care positions must be proficient in spoken and written English as required by 38 U.S.C. 7402(d) and 7407(d). Education IMPORTANT: A transcript must be submitted with your application if you are basing all or part of your qualifications on education. Note: Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. You can verify your education here: If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. For further information, visit: Additional Information Annual leave shall accrue for full-time Nurses, and Nurse Anesthetists at the rate of 8 hours for each full biweekly pay period. This job opportunity announcement may be used to fill additional vacancies. It is the policy of the VA to not deny employment to those that have faced financial hardships or periods of unemployment. This position is in the Excepted Service and does not confer competitive status. VA encourages persons with disabilities to apply. The health-related positions in VA are covered by Title 38, and are not covered by the Schedule A excepted appointment authority. Veterans and Transitioning Service Members: Please visit the VA for Vets site for career-search tools for Veterans seeking employment at VA, career development services for our existing Veterans, and coaching and reintegration support for military service members. If you are unable to apply online view the following link for information regarding an Alternate Application.