Job at a glance
The Registered Nurse (RN) Community Care Case Manager ensures Veterans receive timely, coordinated, high-quality care. This role manages referrals from intake to resolution, collaborating with VA teams and community providers. Using advanced clinical judgment, the RN assesses needs, creates individualized care plans, and guides smooth transitions between VA and community services-delivering the right care, at the right time, in the right setting.
Major duties: The Community Care Case Manager is a Registered Nurse, qualified by education and experience. The Case manager will provide direct support to the Non-VA Care program in planning, designing, integrating, implementing, modifying, and evaluating the effectiveness of program components and services to improve the quality of patient care and the appropriateness and timeliness of services provided.
Duties include but are not limited to: Responsible for executing a streamlined approach to receiving, triaging, and directing timely, coordinated care. Demonstrates proficient practice and decision-making, deliberate planning, and critical thinking skills. Providing the clinical leadership and expertise for the coordination of NMVAHCS non-VA care authorization program. Demonstrate knowledge of Fee federal regulations, VHA guidelines, medical review criteria, care management and utilization management processes, inter-facility transfer and travel processes, clinical document requirements, current standards of care, and compliance guidelines.
Provide clinical oversight of the non-VA care approval process is provided by each medical center Chief of Staff and/or designated appointee. Supports the medical center's mission to improve timely access to care, ensure Veterans who want to receive care in the community are referred and scheduled into the community, and support. Serves as a liaison to both internal and community providers and is responsible for managing the care of the Veteran throughout the consult process.
Work collaboratively within the Office of Integrated Veteran Care (IVC) to triage Request for Services (RFS) to coordinate care processes defined by the IVC Field Guidebook to include developing a care coordination plan, reviewing medical documentation from community providers, communication of care coordination needs, and supporting the Veteran through the completion of the episode of care. 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 thru Friday 7:30am-4:00pm Telework: Not Authorized Virtual: Not Authorized Relocation/Recruitment Incentives: Not authorized Permanent Change of Station (PCS): Not authorized Financial Disclosure Report: Not required Requirements: U.S.
Citizenship; non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy. All applicants tentatively selected for VA employment in a testing designated position are subject to urinalysis to screen for illegal drug use prior to appointment. Applicants who refuse to be tested will be denied employment with VA. Selective Service Registration is required for males born after 12/31/1959.
Subject to background/security investigation. Selected applicants will be required to complete an online onboarding process. Acceptable form(s) of identification will be required to complete pre-employment requirements (https://www.uscis.gov/i-9-central/form-i-9-acceptable-documents). Effective May 7, 2025