The Remote Patient Monitoring-Home Telehealth (RPM-HT) RN Care Coordinator (RNCC) will be responsible and accountable for all elements of the nursing process when providing and/or supervising direct patient care. The goal of RPM-HT is to improve clinical outcomes and access to care while reducing complications, hospitalizations, and clinic or emergency room visits.

Duties

Duties include but not limited to: RN Care Coordinators are case managers and health coaches who are highly skilled and have specific training and competency in the use of disease management, health care informatics, and remote patient monitoring technologies. Case management is the cornerstone of Remote Patient Monitoring Home Telehealth. Regular chart reviews and monitoring. There is a primary focus on enhancing patient self-management, education on the disease-specific elements of care, and oversight of health-related behaviors associated with positive patient outcomes. RPM HT care coordination process begin at identification of appropriate Veterans for enrollment and ends at patient discharge and transition from the program. RNCCs emphasize collaboration and engage in processes that assess, advocate, plan, implement, coordinate, monitor, and evaluate health care options and services to meet the needs of the individual Veteran. Providing initial and ongoing comprehensive assessment, including a review of systems that establish a comprehensive plan of care. The RNCC identifies, analyzes, and prioritizes problems and interventions and sets appropriate measurable goals (i.e., Simple, Measurable, Achievable, Realistic, Time-based care plan and is completed in collaboration with PACT, HBPC, mental health care, and other specialty services, as appropriate for each Veteran enrolled in the program. The treatment plan is an extension of the Veteran's primary care plan and is completed in collaboration with PACT, HBPC, mental health care, and other specialty care services, as appropriate for each Veteran enrolled in the program. Triaging and assessing all data received from RPM HT patients, such as vital signs, reported symptoms, and question responses. The RNCC will review daily responses each workday and contact Veterans about worrisome responses and trends, significant changes in condition, or changes in other specific data elements received, as clinically appropriate. Ideally, RNCCs should contact Veterans when responses indicate that an issue may be developing in order to provide education, offer self-management tips, and assist with problem-solving rather than waiting until a red alert signals that the situation may be out of control. Identifying, and intervening to address, potential exacerbations or complications in order to facilitate timely care in a clinic, emergency response or urgent care setting, or care in the community. Providing appropriate interventions, such as medication management, case management, and patient education. Triaging incoming calls and concerns of Veterans. Providing communication and data exchange with community-based providers when there is co-managed care. Providing interdisciplinary consultation and interventions, such as with HBPC and other non-institutional care programs and venues, mental health, social work, pharmacy, nutrition, etc. Identifying patient knowledge, health factors, skills, and behaviors that support self-management, and identifying gaps. Providing health coaching, patient education, and psychosocial support. Documenting and communicating with PACT or specialty care service members about changes in status, progress toward goals, patterns or trends in data, symptoms or findings of concern, needs for provider assessment or intervention. Facilitating, documenting, and communicating treatment changes to the Veteran, as directed by providers, and providing a follow-up evaluation of the Veteran after changes are implemented. Providing support and guidance and reviewing changes in medications, goals, and the treatment plan with Veterans during and after transitions in care, such as after a hospital discharge. Assessing and analyzing outcome indicators and developing plans for both individual Veterans and aggregate populations to enable continuous performance improvement. Participating in peer review of documentation for continuous performance improvement. 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 to 4:00pm Telework: Telework Eligible -as determined by the agency policy. Click to Add Telework Description This position is not approved to be a 100% Virtual/Remote position. Virtual: This is not a virtual position. Relocation/Recruitment Incentives: Not Authorized Permanent Change of Station (PCS): Not Authorized Financial Disclosure Report: Not required

Requirements

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. 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/12323967. 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: VA Regulations, specifically VA Handbook 5005, Part II, Appendix G-6 Nurse Qualification Standard. This can be found in the local Human Resources Office. Preferred Experience: 2 YEARS IN-PATIENT RN EXPEREINCE PREFERRED Physical Requirements: Light Carrying, under 15 lbs., use of fingers, ability to distinguish basic colors Environmental Factors: Working closely with others, working alone

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.

Note: The National League for Nursing Accrediting Commission/NLNAC changed its name to ACEN in May 2013. ACEN's website may be utilized to verify accredited programs using automated inquiry processes; however, for verification of any nursing program's accreditation prior to 1998, an automated inquiry cannot be used and ACEN must be contacted directly via their email contact information on the ACEN website to verify.)

Note: In order to grant credit towards an appointment based on foreign nursing education higher than the associate degree level, formal degree equivalency validation from a recognized degree equivalency evaluation agency accepted by VA such as the International Consultants of Delaware (ICD) must be obtained

Contacts

• Address Anchorage VA Medical Center 1201 North Muldoon Road Anchorage, AK 99504 US
• Name: Shelly Graham
• Phone: 503 220-8262 X55320
• Email: [email protected]