The Remote Patient Monitoring (RPM) Home Telehealth (HT) Registered Nurse (RN) Case Manager demonstrates creative approaches to the management of aspects of complex patient care. HT is a program that applies care and case management principles to coordinate care using health informatics, disease management and HT technologies to facilitate access to care and to improve the health of Veterans with the specific intent of providing the right care, in the right place, at the right time.
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/12688866. 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: For more information on this qualification standard, please visit https://www.va.gov/ohrm/QualificationStandards/. Preferred Experience: Education: BSN preferred. Experience: RN with at least three (3) years successful nursing practice. Excellent Interpersonal Relationship skills. Home Telehealth and/or case management experience preferred. Ability to work independently. Proficient typing required and computer skills preferred, including basic IT knowledge. Physical Requirements: Light lifting, under 15 pounds; Light carrying, under 15 pounds; Use of fingers; Both hands required; Walking (.5 hours); Specific visual requirement (see computer screen) Environmental Factors: Working alone
RPM-HT is defined as a program into which Veterans are enrolled that applies care and case management principles to coordinate care using health informatics, disease management and technologies such as in-home and mobile monitoring, and/or video technologies. The goal of Home Telehealth is to improve clinical outcomes and access to care while reducing complications, hospitalizations, and clinic or emergency room visits for Veterans in post-acute care settings, high-risk Veterans with chronic disease or Veterans at risk for placement in long-term care. The RPM-HT nurse case manager (NCM) is an expert nurse who serves as an advocate for Veterans managing complex diseases. Heavy workloads and other challenges are inherent in this role; however, being a NCM offers fulfilling Veteran-nurse relationships where individualized assistance enhances health outcomes. Duties may include but are not limited to: Triage and assess all data received from Home Telehealth patients such as vital signs, reported symptoms, and question responses. Contact patients with high risk responses, significant changes in condition, or changes in other specific data elements received. Identify and intervene for potential exacerbations or complications to facilitate: - PACT clinic, Pharm D, ED/urgent care, or care in the Community - Provider-directed interventions such as medication management Triage calls and concerns of patient/family, resolve those within scope of practice, and route others to primary care staff or other services as indicated. Provide opportunity for extension of length of time between routine primary care , Mental Health, and/or or HBPC encounters for stable patients. Provide communication and data exchange with community-based providers when there is comanaged care. Provide psychosocial support to patients. Provide interdisciplinary consultation and interventions such as with HBPC and other non-institutional care programs and venues, mental health, social work, pharmacy, nutrition, etc. Identify patients' knowledge, health factors, skills, and behaviors that support self-management and identify gaps therein. Provide health care coaching, patient education, and motivational counseling. Communicate with provider regarding progress to goals; patterns or trends of data, symptoms or findings; concerning findings; need for provider assessment and/or interventions. Facilitate and communicate treatment changes directed by the provider and provide follow up evaluation of the patient after the changes are implemented. Adhering to program requirements for documentation of patients and progress following admission, at least twice yearly periodic evaluations, red alerts, and with changes in condition/ hospitalizations. Mandatory Training: Within the first two weeks of the hire the incumbent must complete and pass all required education from the Office of Telehealth Services. Additional mandatory training includes annual competencies related to Home Telehealth RN Care Coordination. Work Schedule: Monday through Friday, 7:30am to 4:00pm (Tour times may vary, dependent on unit needs) Telework: Not available Virtual: This is not a virtual or remote position. Relocation/Recruitment Incentives: Not authorized Permanent Change of Station (PCS): Not authorized 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