RN Case Manager

BUFFALO VETERANS HOSPITAL IS LOOKING TO HIRE A RN CASE MANAGEMENT COORDINATOR: One (1) Full-Time Position

Tours: Monday through Friday 7:30am to 4:00pm.

Job Description:

The CMC RN conducts medical records evaluations and medical record abstraction of health information to serving as the primary resource for completion of medical forms for providers and other staff with patient requests for completion of or concerns related to completion of VA and non-VA forms or provision of medical statements. This person provides professional expertise in accurately managing questions or issues at the local facility level staff and patient requests related to the completion of VA and non-VA forms or provisions of medial statements. The RN serves in accordance with VHA policy for completion of the VA forms, non-VA medical forms, and providing medical statements with respect to the patient’s medical condition and functionality in accordance with the health information contained in the health record and verified by the assigned provider via review and signature as requested by the Veteran, Veteran’s personal; representative, or respective 3rd party.

Supports Veteran care and counseling of persons or in the promotion and maintenance of health and prevention of illness and injury based upon the medical record reviews for the purpose of form completion which includes systematic data gathering, assessment, appropriate nursing judgment, and evaluation of human responses to actual or potential health problems through such services as case finding, reviews of received health teaching, health counseling; provision of care supportive to or restorative of life and well-being. The nurse’s primary commitment is to the patient, whether an individual, family, group, or community. (ANA Code of Ethics for Nurses). The registered nurse, as a licensed professional, is responsible and accountable for his/her practice.

Executes position responsibilities that demonstrates leadership, experience, and creative approaches to management of complex patient care in relation to VA forms, non-VA forms, and provision of medical statements. The registered nurse will aid the requestor and VA medical provider in the completion VA forms such as application for clothing allowance form, aid and attendance pension forms, housebound pension forms, survivors pension forms, vocational rehabilitation forms, disability benefits questionnaires (DBQ) and Veterans Benefits Administration (VBA) and coordinating with the medical provider for completion of provision of medical statements to support VA benefits claims. The registered nurse will aid the requestor and VA medical provider in the completion non-VA forms such as Family Medical Leave Act forms, life insurance forms, non-VA disability forms, return to work/work status forms, medical clearance forms, state and federal workers compensation forms, permits, medical necessity or accommodation forms, capacity evaluations forms, social security administration (SSA) examinations forms, Department of Defense (DoD)/military forms, attorneys’ forms, and any other form submitted on behalf of the Veteran. When completion of the form extends beyond the scope of the medical documentation contained therein the Veteran medical records, the registered nurse will coordinate consultation with appropriate specialty care services, (e.g., physical therapy, occupational therapy, blind rehabilitation, kinesiotherapy, mental health, neurology, orthopedics, audiology, cardiology, physiatry, etc.) or primary medical care provider. The registered nurse will coordinate with the medical provider when a descriptive statement is requested to be put into their VA electronic health record regarding the current status of an existing medical condition, disease, or injury that includes a statement of diagnosis, prognosis, and assessment of function for purposes other than VA disability claims, such as for submission to non-VA entities. The registered nurse will adhere to VHA privacy and release of information policies and procedures must be applied prior to releasing any medical statements or medical forms completed on behalf of the Veteran. A written request from the patient or third party authorization is required in accordance with VHA Handbook 1605.1, Privacy and Release of Information and VHA Handbook 1907.06, Management and Release of Information, using VA Forms 10-5345a or 10-5345. A copy of the medical statement (unless entered directly into the Veterans’ health record as a progress note) or the completed paper medical form, along with the requisite written request or authorization, must be scanned into Veterans Health Information Systems and Technology Architecture (VistA) Imaging. The registered nurse will serve as the Facility Medical Statements and Forms Point of Contact. They will function to respond to questions or issues from local facility level staff and patients related to the completion of VA and non-VA forms or provision of medical statements, serving as a resource to providers and other staff with patient requests or concerns related to completion of VA and non-VA forms or provision of medical statements, consulting on issues that cannot be resolved at the local facility or VISN level, as needed.

SCOPE OF ASSIGNED DUTIES:

1. The RN provides oversight and coordinates completion, to meet VHA policy that when requested, completion of VA and non-VA medical forms and provide medical statements with respect to the patient’s medical condition and functionality in accordance with the medical records and professional judgement. The RN facilitates system-wide improvements at VA Western New York Healthcare System related to form completion.

2. The RN supports a specific population of patients in a variety of settings. These settings include primary care, specialty care, multidisciplinary clinics, and inpatient care. The RN provides a unique approach to meet the needs of the Veteran through a “no wrong door” approach that incorporates traditional nursing skills and administrative support across the continuum and healthcare setting to meet the needs of form completion for the Veteran population.

3. The RN is part of a multidisciplinary team that focuses on identifying and eliminating barriers to form completion and coordinating completion with the medical provider when needed to ensure that patients’ needs are met in the full continuum of supporting their needs.

4. The RN provides timely access to support Veterans and requestors form completion needs with high-quality, well-coordinated care through the application of the nursing process, medical model, and using patient-driven principles of care. Specific functions of the RN include: 1) identifying the patient’s medical and psychosocial issues through medical records reviews in accordance with requested form completion 2) coordinating with the Primary Care or specialty care team for form completion when forms cannot be completed through record review 3) coordinating with the Medical Provider for review, validation, and signature of the completed form 4) working effectively with all levels of staff, promoting collaborative efforts, acting as a liaison between the patients and release of information staff and the providers, and facilitating communication among the multidisciplinary care team to ensure timely and accurate form completion, coordinating with clinic medical administration staff in scheduling appointments for Veterans when needed for form completion 5) demonstrating knowledge of clinical guidelines and specialty resources throughout the continuum of care 6) tracking and monitoring form completion from receipt, completion, and release across the continuum; 7) providing anticipatory guidance and managing expectations with education and appropriate referrals to assist patients and requestors in form completion; and 8) providing timely communication to the Veteran and third parties in the updates, needs, and barriers in the form completion process to ensure the Veteran is educated and aware of the status of their form completion to meet their health needs; 9) promoting patient-driven care with optimal outcomes through advocacy, providing and reinforcing education, facilitating healthcare team communication/care conferences as needed, and promoting health promotion and risk reduction strategies for patients and their caregivers in the facilitation of form completion.

4.The RN demonstrates leadership in delivering and improving form completion management across the continuum, through collaborative strategies that include:1) providing local support to staff/providers in a variety of settings throughout the facility; 2) working with third party stakeholders to identify needs, system issues, and communicate activities of the registered nurse 3) supporting release of information practices, policies, and procedures. efforts with primary care, referring VA facilities, and community; 4) participating in quantitative and qualitative data collection efforts as needed to support program evaluation and quality improvements; 6) assisting barrier analysis and identification of barriers for the delays in the form completion process; and 7) participating in local and VISN release of information meetings and education.

Specific Qualification:

• A minimum of 3-5 year’s experience in nursing practice in a variety of clinical settings with increasing degrees of responsibility, required.
• Ability to work collaboratively in applying clinical expertise and knowledge of healthcare to minimize risk and optimize patient oversite, required.
• Knowledge of Microsoft Office, required.
• Bachelor of Science degree in nursing, required. Master of Science in Nursing or equivalent, preferred.
• Demonstrate use of sound judgment in clinical and administrative decisions.
• Communicate effectively both orally and in writing with professional, administrative, and technical staff.
• Demonstrate experience in program development and/or management.

Job Type: Full-time

Pay: $97,170.41 - $116,807.37 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Flexible spending account
• Health insurance
• Life insurance
• Paid sick time
• Paid time off
• Referral program
• Retirement plan
• Vision insurance

Medical specialties:

• Primary Care

Schedule:

• 5x8
• 8 hour shift
• Monday to Friday

Work setting:

• Hospital
• In-person

Ability to Relocate:

• Buffalo, NY 14215: Relocate before starting work (Required)

Work Location: In person