This Advanced Illness Care Coordinator demonstrates leadership, experience, and creative approaches to management of complex patient care. The AICC RN leads and organizes delivery of care to assure continuity of care and peer accountability for practice, including access to care and discharge planning; Uses advanced clinical knowledge in planning, decision-making, and evaluating outcomes. Practices standard of care and identify new approaches and maintain knowledge of national HPC metrics.

Duties

Duties include, but are not limited to: Hospice & Palliative Care Program Continuous study of standards of care and new approaches, staff support Working knowledge of national HPC metrics BFS, Veteran Support Service Center review SMART goals, monitor outcomes, provide education Monitor inpt and outpt palliative and end of life care for our Veterans Track & report program data for national metrics and local issues GOC conversations Coaching We Honor Veterans inpatient program Benefits from support of CDCE and community groups No Veteran Dies Alone inpatient program Relies on volunteer and staff engagement Bereavement coordination Calls and cards Referrals to community supports Volunteer coordination Screening Orientation Education Ongoing support Purchase card holder In conjunction with Center Development Civil Engagement monitor donations Manage program supplies needed i.e.: flag blankets, pins for WHV presentations Tracking and documentation of spending Documentation with attention to clinics, note titles, consults VISN and National HPC meetings Veteran-centered Collaboration among disciplines and across care teams re: engagement and delivery of care Analyze and address unique problems and situations Manage consults from entry to completion and through follow-up Inpatient visits, initial and ongoing care throughout end of life stay Home visits, initial and follow up as needed Telehealth visits, initial and follow up as needed Documentation Monitor delivery of care in both CLC/community and facilitate as needed Working knowledge of VA and community resources Working knowledge of referral process, admissions process, and private insurance vs. VA pay i.e. community care Assist VA and outside staff with accessing palliative and hospice care placement and coverage for Veterans Education Veterans and families/caregivers Staff Psychological support IDT meetings, care plans GOC conversations Conducting Facility-centered Education for staff, promote knowledge of and comfort with delivering palliative care/hospice in conjunction with DLO plan for staff HPC yearly competencies Collaborate with other programs to provide Hospice Palliative Care education ex: Caregiver Support, Home Based Primary Care, Community Living Center staff As-needed training to address emergent issues/questions Ethics Consult Service team member Community Care Consults for palliative care and hospice (this falls under other duties as assigned, dates back to Non-VA Care before Community Care was created) Clinical review. CNH RN (this falls under other duties as assigned, pre-dates establishment of NIC program) Clinical review of Veteran care, RN visits to Veterans (each visit includes obtaining clinical data from staff, interviewing Veteran and interviewing family), RN clinical review of data from Medicare Compare for contract renewals, annual inspection for performance eval HPC section on SharePoint maintained and updated by Education dept Memorial Services by Chaplaincy supported by AICC and IT PRIs Community-centered Liaison with Veteran and other groups in community (ex: Finger Lakes Painters) in cooperation with CDCE Ongoing donations for support of VA HPC Hospice Veteran Partnership Maintain relationships with community home care & hospice agencies, comfort care homes, other HPC-supporting community resources Education Customer service, facilitate communication between outside services and VA providers Address gaps in delivery of care, challenges for Vets/agencies 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, 7:30am-4:00pm Relocation/Recruitment Incentives: May be authorized EDRP Authorized: Contact the EDRP Coordinator for questions/assistance. Learn more Financial Disclosure Report: Not required

Requirements

Qualifications

Applicants pending the completion of educational or certification/licensure requirements may be referred and tentatively selected but may not be hired until all requirements are met. Basic Requirements: United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. English Language Proficiency. In accordance with 38 U.S.C. 7402(d), 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 State-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). In cases of graduates of foreign schools of professional nursing, possession of current, full, active and unrestricted registration will meet the requirement of graduation from an approved school of professional nursing. OR 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. Students should submit the certificate of professional nursing to sit for the NCLEX to the VA along with a copy of the MSN transcript. (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. 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. Grade Determinations: The following criteria must be met in determining the grade assignment of candidates, and if appropriate, the level within a grade: Nurse I Level I - An Associate Degree (ADN) or Diploma in Nursing, with no additional nursing practice/experience required. Nurse I Level II - An ADN or Diploma in Nursing and approximately 1 year of nursing practice/experience; OR an ADN or Diploma in Nursing and a bachelor's degree in a related field with no additional nursing practice/experience; OR a Bachelor's of Science in Nursing (BSN) with no additional nursing practice/experience. Nurse I Level III - An ADN or Diploma in Nursing and approximately 2-3 years of nursing practice/experience; OR an ADN or Diploma in Nursing and a Bachelor's degree in a related field and approximately 1-2 years of nursing practice/experience; OR a BSN with approximately 1-2 years of nursing practice/experience; OR a Master's degree in nursing (MSN) or related field with a BSN and no additional nursing practice/experience. Nurse II - A BSN with approximately 2-3 years of nursing practice/experience; OR ADN or Diploma in Nursing and a Bachelor's degree in a related field and approximately 2-3 years of nursing practice/experience; OR a Master's degree in nursing or related field with a BSN and approximately 1-2 years of nursing practice/experience; OR a Doctoral degree in nursing or meets basic requirements for appointment and has doctoral degree in a related field with no additional nursing practice/experience required. Nurse III - Master's degree in nursing or related field with BSN and approximately 2-3 years of nursing practice/experience; OR a Doctoral degree and approximately 2-3 years of nursing practice/experience. Reference: VA Regulations, specifically VA Handbook 5005, Part II, Appendix G-6 Nurse Qualification Standard. This can be found in the local Human Resources Office. Physical Requirements: The population of male and female veterans served ranges from the adult age 18, to the elderly adult age 65 and over. Bath VA Medical Center has in-patient medical settings, outpatient settings, Community Living Center and a Domiciliary Program. The Bath VAMC and Community Based Outpatient Clinics provide primary care, specialty care, mental healthcare, alcohol and drug rehabilitation, routine lab work, immunizations and wellness and disease management programs. There is a large outpatient population, with visits to the Emergency Department and admissions for medical co-morbidities. 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. 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.

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: http://ope.ed.gov/accreditation/. 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: http://www.ed.gov/about/offices/list/ous/international/usnei/us/edlite-visitus-forrecog.html.

Contacts

• Address Bath VA Medical Center 76 Veterans Avenue Bath, NY 14810 US
• Name: Darci Cook
• Phone: 315-425-4400
• Email: [email protected]