Vocational Nurse

3 weeks ago

Santa Rosa, California, United States Veterans Affairs, Veterans Health Administration Full time
Job Summary

We are seeking a skilled Vocational Nurse to join our team as a Medical Review Specialist. In this role, you will be responsible for reviewing non-VA health care records to determine medical necessity of visits, differentiating between emergent and non-emergent situations.

Responsibilities
  • Perform retrospective medical review of non-VA health care records to determine medical necessity of visit
  • Review medical record documentation for requests for service (RFS) of authorized community care consults to determine RFS indicated medical necessity and urgency
  • Refer complex cases to the CCRNs for more in-depth review
  • Analyze submitted medical documentation to ensure all components necessary to aid in medical record review are present
  • Request additional medical documentation as needed
  • Using professional standards of care, recognize deviations from patient's baseline and respond to patient's immediate and long-term needs
  • Utilize knowledge of physical, social, and emotional factors when planning patient care
  • Apply knowledge of Medical Center Policies and Procedures to daily clinical functions and responsibilities
  • Ensure actions and interactions are within the guidelines of VHA and Office of Community Care directives and policies
  • Using clinical pathways to promote staff involvement in the team environment for patient-centered care
  • Using professional standards of care, scientific evidence, and practice to evaluate programs and/or service activities
  • Communicate a plan with the patient and/or caregiver and referring and accepting provider
  • Operate in an interactive way with all members of the clinical and administrative staff
  • Perform consult review, consult routing, and completion of consults
  • Indirect patient care: returning telephone calls, responding to patient emails/inquires, actively managing and renewing prescriptions, reviewing clinical data, communicating normal results to patients, communicating with other VA service departments for technical and equipment needs, and communicating with primary care providers and other referring specialists, as appropriate
Requirements
  • United States Citizenship
  • Graduate of a school of practical or vocational nursing approved by the appropriate state agency and/or accredited by the National League for Nursing Accrediting Commission (NLNAC)
  • Full, Active, Current and Unrestricted license as a licensed practical or vocational nurse in a State, Territory or Commonwealth of the United States or District of Columbia
  • English Language Proficiency
  • GS-03 to GS-06 grade level
Working Conditions

This position requires Visual Acuity, keen hearing, clear distinctive speech, Moderate Lifting up to 35 pounds, Walking, Standing intermittently up to 4 hours, Ability for rapid mental and muscular coordination simultaneously, Ability to distinguish shades of colors, Intermittent typing, Sitting, Bending and stooping, Reaching above shoulder, Fine motor movement of hands/fingers, Hearing acuity to auscultate using stethoscope, Corrected Vision to 20/30, ability to exert 20 pounds of pressure to compress adult chest 2 inches for CPR, Frequent hand washing/sanitizing required.

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